Red Cell Transfusion “Trigger”: A Review
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Abstract:
Despite the publication of several consensus guidelines that set forth recommendations for the transfusion of red cells, actual clinical practice continues to vary widely. Animal data and studies in human volunteers and patients support a red cell transfusion threshold of 7 to 8 g/dl in most patients. However, conflicting data, particularly in cardiac patients and in the elderly, suggest that it may be impossible to define a single red cell "trigger" for all patients. A well-designed, randomized, controlled trial is still needed to establish a safe threshold for red cell transfusion in adults with coronary artery disease.Keywords:
Red Cell
Transfusion Therapy
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Objective:To discuss the efficiency of red blood cell transfusion in order to provide the basis for the clinical reasonable effective blood transfusion.Method:The transfusion conditions and effects of 1056 patients received red blood cell transfusion from January, 2010 to December period were retrospectively analyzed.Result:Red blood cell transfusion effectiveness was 85.5%. There was invalid blood transfusion phenomenon in the majority of clinical departments. The effective blood transfusion rate of pediatrics department was highest (100%), while of surgical department was lowest (82.1%).Transfusion effectiveness had no relation with sex and age, and decreased with the increases of the blood transfusion number.Conclusion:Clinical safe, reasonable individuation blood transfusion plan would be helpful to enhance the efficiency of red blood cell transfusion.
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Red Cell
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Red Cell
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Background and Objectives Cardiac surgery, utilizing extracorporeal circulation, is associated with a heavy fluid load that may significantly depress haemoglobin concentration. Thus, considering haemoglobin alone may be an inaccurate method of replacing red cell volume loss. This study was designed to examine the impact on red cell transfusion of a red cell volume‐based guideline. Materials and Methods Patients were randomized to receive red cells as dictated by the red cell volume‐based guideline or a haemoglobin‐based protocol. End‐points considered were red cell transfusion and clinical outcome. Results Patients transfused as per the red cell volume‐based guideline received significantly less red cells with no associated difference in clinical outcome. Conclusion Considering haemoglobin concentration alone may significantly overestimate the requirement for red cell transfusion in elective cardiac surgery patients.
Red Cell
Guideline
Extracorporeal circulation
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as Standardised Products with Specified Properties?It has become an established practice to William L. Bayer, MD consider plasma derivatives as biologicals of human origin and to subject them to strict quality controls.There is an increasingand
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Blood preservation
Blood cell
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Abstract Carnitine is bound by intact red blood cells, by red blood cell ghosts, and by glutaraldehyde‐fixed human erythrocytes in a non‐saturable, temperature‐dependent manner. Binding of carnitine by these preparations is blocked by sulfhydryl reagents. Incubation or preincubation of red blood cell preparations with carnitine inhibits the aggregation of erythrocytes otherwise elicited by fibrinogen. Identical effects are obtained with red blood cell ghosts. In contrast, choline, even at high concentrations, is inactive in preventing the aggregation of erythrocytes. We discuss possible mechanisms by which carnitine favors the dispersion of red blood cells, and we present data indicating that sulfhydryl groups on erythrocyte membranes are required to permit these carnitine actions to be manifested.
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Band 3
Choline
Blood cell
Glutaraldehyde
Methemoglobin
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Passive haemagglutination inhibition (PHI) was adapted to quantitate red cell associated IgG. Twenty one patients with autoimmune haemolytic anaemia (AIHA) had a raised red cell associated IgG, mean (SD) = 5.783 (6.183) ng/10(6) red blood cell compared with that of 69 subjects with a red cell associated IgG of 0.433 (0.349) ng/10(6) red blood cell. Thirteen of 14 blood donors with a positive direct antiglobulin test (DAGT) had a normal red cell associated IgG. The only blood donor with positive DAGT and raised red cell associated IgG had AIHA. Studies of red cell associated IgG in other groups of patients were also undertaken. The technique is simple, does not require the use of sophisticated equipment, and is suitable as a routine test in hospital laboratories. The results of red cell associated IgG by PHI are reproducible and clinically relevant.
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In a group of 12 subjects with essential hypertension (EH), we evaluated the erythrocyte membrane fluidity and red cell membrane transverse fluidity gradient. We also evaluated the total red cell Ca content, the red cell cytosolic free calcium, the red cell membrane cholesterol/phospholipid ratio and the red cell membrane individual phospholipids. From the data obtained, it is evident that the erythrocyte membrane fluidity and red cell membrane transverse fluidity gradient discriminate normals from hypertensives. None of the red cell metabolic parameters is able, however, to differentiate normals from hypertensive subjects. Our data underline the abnormality of the red cell membrane dynamic properties in hypertension; this abnormality is not, however, related to the red cell metabolic parameters considered.
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Cell membrane
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Objective To evaluate the clinical factors associated with red blood cell transfusion effectiveness.Methods446 patients(566 transfusions) received red blood cell transfusion from Jan 2008 to Jun 2010 were analyzed retrospectively.807 and 85 patients were in the effective transfusion and ineffective transfusion group respectively.The potential factors associated with red blood cell transfusion effectiveness were evaluated by the method of Logistic regression.Results The single factor analysis showed that blood transfusion history(χ2= 81.49,P = 0.00),the infection(χ2= 33.32,P =0.00),the splenohepatomegalia(χ2= 4.81,P = 0.03),and the malignant disease(χ2= 105.7,P = 0.00) were associated with the effectiveness of red blood cell transfusion.Binary conditional logistic regression analysis showed that the blood transfusion history(OR = 2.41,P = 0.001) and the malignant disease(OR = 2.86,P = 0.00) were independent factors for effectiveness of red blood cell transfusion.Conclusion The patients with blood transfusion history and malignant disease were at the high risk for ineffectiveness of red cell blood transfusion.
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