Document Detail

Transfusion of stored autologous blood does not alter reactive hyperemia index in healthy volunteers.
MedLine Citation:
PMID:  22531338     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transfusion of human blood stored for more than 2 weeks is associated with increased mortality and morbidity. During storage, packed erythrocytes progressively release hemoglobin, which avidly binds nitric oxide. We hypothesized that the nitric oxide mediated hyperemic response after ischemia would be reduced after transfusion of packed erythrocytes stored for 40 days.
METHODS AND RESULTS: We conducted a crossover randomized interventional study, enrolling 10 healthy adults. Nine volunteers completed the study. Each volunteer received one unit of 40-day and one of 3-day stored autologous leukoreduced packed erythrocytes, on different study days according to a randomization scheme. Blood withdrawal and reactive hyperemia index measurements were performed before and 10 min, 1 h, 2 h, and 4 h after transfusion. The reactive hyperemia index during the first 4 h after transfusion of 40-day compared with 3-day stored packed erythrocytes was unchanged. Plasma hemoglobin and bilirubin concentrations were higher after transfusion of 40-day than after 3-day stored packed erythrocytes (P = 0.02, [95% CI difference 10-114 mg/l] and 0.001, [95% CI difference 0.6-1.5 mg/dl], respectively). Plasma concentrations of potassium, lactate dehydrogenase, haptoglobin, and cytokines, as well as blood pressure, did not differ between the two transfusions and remained within the normal range. Plasma nitrite concentrations increased after transfusion of 40-day stored packed erythrocytes, but not after transfusion of 3-day stored packed erythrocytes (P = 0.01, [95% CI difference 0.446-0.66 μM]).
CONCLUSIONS: Transfusion of autologous packed erythrocytes stored for 40 days is associated with increased hemolysis, an unchanged reactive hyperemia index, and increased concentrations of plasma nitrite.
Lorenzo Berra; Andrea Coppadoro; Binglan Yu; Chong Lei; Ester Spagnolli; Andrea U Steinbicker; Kenneth D Bloch; Tian Lin; Fatima Y Sammy; H Shaw Warren; Bernadette O Fernandez; Martin Feelisch; Walter H Dzik; Christopher P Stowell; Warren M Zapol
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesiology     Volume:  117     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-21     Completed Date:  2013-07-08     Revised Date:  2014-06-09    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-63     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Preservation
Blood Transfusion, Autologous / adverse effects*
Cross-Over Studies
Hyperemia / etiology*
Nitric Oxide / metabolism
Nitrites / blood
Grant Support
G0701115//Medical Research Council; R01 DK082971/DK/NIDDK NIH HHS
Reg. No./Substance:
0/Nitrites; 31C4KY9ESH/Nitric Oxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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