| Perfusion vs. oxygen delivery in transfusion with "fresh" and "old" red blood cells: the experimental evidence. | |
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MedLine Citation:
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PMID: 20646963 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We review the experimental evidence showing systemic and microvascular effects of blood transfusions instituted to support the organism in extreme hemodilution and hemorrhagic shock, focusing on the use of fresh vs. stored blood as a variable. The question: "What does a blood transfusion remedy?" was analyzed in experimental models addressing systemic and microvascular effects showing that oxygen delivery is not the only function that must be addressed. In extreme hemodilution and hemorrhagic shock blood transfusions simultaneously restore blood viscosity and oxygen carrying capacity, the former being critically needed for re-establishing a functional mechanical environment of the microcirculation, necessary for obtaining adequate capillary blood perfusion. Increased oxygen affinity due to 2,3 DPG depletion is shown to have either no effect or a positive oxygenation effect, when the transfused red blood cells (RBCs) do not cause additional flow impairment due to structural malfunctions including increased rigidity and release of hemoglobin. It is concluded that fresh RBCs are shown to be superior to stored RBCs in transfusion, however increased oxygen affinity may be a positive factor in hemorrhagic shock resuscitation. Although experimental studies seldom reproduce emergency and clinical conditions, nonetheless they serve to explore fundamental physiological mechanisms in the microcirculation that cannot be directly studied in humans. |
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Authors:
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Amy G Tsai; Axel Hofmann; Pedro Cabrales; Marcos Intaglietta |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review Date: 2010-06-19 |
Journal Detail:
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Title: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis Volume: 43 ISSN: 1473-0502 ISO Abbreviation: Transfus. Apher. Sci. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-09 Completed Date: 2010-12-10 Revised Date: 2011-08-03 |
Medline Journal Info:
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Nlm Unique ID: 101095653 Medline TA: Transfus Apher Sci Country: England |
Other Details:
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Languages: eng Pagination: 69-78 Citation Subset: T |
Copyright Information:
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(c) 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Bioengineering, University of California, San Diego, CA 92093-0412, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Preservation Erythrocyte Transfusion / methods* Erythrocytes / cytology, metabolism* Humans Microcirculation Oxygen / administration & dosage*, blood |
| Grant Support | |
ID/Acronym/Agency:
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R01-62354//PHS HHS; R24-64395//PHS HHS |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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