Blood shortages planning in Canada: <scp>The National Emergency Blood Management Committee</scp> experience during the first 6 months of the <scp>COVID</scp>‐19 pandemic

Prokopchuk‐Gauk, Oksana; Petraszko, Tanya; Nahirniak, Susan; Doncaster, Cheryl; Lévy, Isidore

doi:10.1111/trf.16661

Cited by 13 publications

(30 citation statements)

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“…Considering the volume of a sphere, (4/3)πR 3 , the radius of gyration (R G ) of the macromolecule provides an estimate of the volume occupied by the extended macromolecule in solution and is calculable from the excluded volume (Equation 4). The arterial blood (0.2 ml) was collected for hematological analyses at the following four time points: before 50% blood withdrawal, immediately after 50% blood withdrawal, 0 (immediately after administration), and at 7 days after administration.…”

Section: Physicochemical Propertiesmentioning

confidence: 99%

“…Nevertheless, blood shortages have recently come to pose severe difficulties worldwide because of decreased blood donation, aging populations, and complex therapies 1 . The pandemic of novel coronavirus disease 2019 (COVID‐19) has accelerated supply and demand imbalances attributable to a declining number of blood donors 2,3 . Consequently, the development of red blood cell (RBC) substitutes that can be stored for a long period and which have no restricted blood type must be developed and used as a medical measure to supplement blood transfusion treatment.…”

Section: Introductionmentioning

confidence: 99%

“…1 The pandemic of novel coronavirus disease 2019 (COVID-19) has accelerated supply and demand imbalances attributable to a declining number of blood donors. 2,3 Consequently, the development of red blood cell (RBC) substitutes that can be stored for a long period and which have no restricted blood type must be developed and used as a medical measure to supplement blood transfusion treatment. Hemoglobin (Hb)-based O 2 carriers (HBOCs) of various types have been manufactured and assessed during the last few decades, [4][5][6][7] such as intramolecular cross-linked Hb, 8,9 polymerized Hb, 10,11 poly(ethylene glycol) (PEG) conjugated Hb, 12,13 and a phospholipid vesicleencapsulating Hb (Hb-vesicle).…”

Section: Introductionmentioning

confidence: 99%

“…28 Sakai et al reported the resuscitative capability of Hb-vesicle from hemorrhagic shock using a practical 50% exchange transfusion rat model. 14 To evaluate the efficacy of HbBv-HSA 3 and HbA-HSA 3 as an RBC substitute, we observed recovery of the systemic conditions after resuscitation from a similar hemorrhagic shock model in anesthetized rats. The circulation parameters, hematological parameters, and blood gas parameters were monitored for 6 h after administration.…”

Section: Introductionmentioning

confidence: 99%

“…HbBv-HSA 3 and HbA-HSA3 Preparation of HbBv-HSA 3 in phosphate-buffered saline (PBS) solution (pH 7.4, [Hb] = 5/dl) was reported earlier 25. The HbA-HSA 3 solution (pH 7.4, [Hb] = 5/dl) was prepared by the same procedure using SMP crosslinker, which differs from the reagent used in a studyF I G U R E 1 Hemoglobin-albumin cluster.…”

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confidence: 99%

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Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

et al. 2022

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A bovine hemoglobin (HbBv) or human adult hemoglobin (HbA) wrapped covalently by human serum albumins (HSAs), hemoglobin–albumin clusters (HbBv–HSA3 and HbA–HSA3), are artificial O2 carriers used as a red blood cell substitute. This article describes the physicochemical properties of the HbBv–HSA3 and HbA–HSA3 solutions, and their abilities to restore the systemic condition after resuscitation from hemorrhagic shock in anesthetized rats. The HbBv–HSA3 and HbA–HSA3, which have high colloid osmotic activity, showed equivalent solution characteristics and O2 binding parameters. Shock was induced by 50% blood withdrawal. Rats exhibited hypotension and significant metabolic acidosis. After 15 min, the rats were administered shed autologous blood (SAB), HbBv–HSA3, HbA–HSA3, or Ringer's lactate (RL) solution. Survival rates, circulation parameters, hematological parameters, and blood gas parameters were monitored during the hemorrhagic shock and for 6 h after administration. All rats in the SAB, HbBv–HSA3, and HbA–HSA3 groups survived for 6 h. The HbBv–HSA3 and HbA–HSA3 groups restored mean arterial pressure after the resuscitation. No remarkable difference was observed in the time courses of blood gas parameters in any resuscitated group except for the RL group. Serum biochemical tests showed increases in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the HbBv–HSA3 and HbA–HSA3 groups compared to the SAB group. Therefore, we observed other rats awakened after resuscitation with HbA–HSA3 for 7 days. The blood cell count, AST, and ALT recovered to the baseline values by 7 days. All the results implied that HbBv–HSA3 and HbA–HSA3 clusters provide restoration from hemorrhagic shock as an alternative material for SAB transfusion.

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Section: Physicochemical Propertiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

et al. 2022

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Intraoperative Blood Management Strategies for Patients Undergoing Noncardiac Surgery

Lenet,

McIsaac,

Hallet

et al. 2023

JAMA Netw Open

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ImportanceThere is marked variability in red blood cell (RBC) transfusion during the intraoperative period. The development and implementation of existing clinical practice guidelines have been ineffective in reducing this variability.ObjectiveTo develop an internationally endorsed consensus statement about intraoperative transfusion in major noncardiac surgery.Evidence ReviewA Delphi consensus survey technique with an anonymous 3-round iterative rating and feedback process was used. An expert panel of surgeons, anesthesiologists, and transfusion medicine specialists was recruited internationally. Statements were informed by extensive preparatory work, including a systematic reviews of intraoperative RBC guidelines and clinical trials, an interview study with patients to explore their perspectives about intraoperative transfusion, and interviews with physicians to understand the various behaviors that influence intraoperative transfusion decision-making. Thirty-eight statements were developed addressing (1) decision-making (interprofessional communication, clinical factors, procedural considerations, and audits), (2) restrictive transfusion strategies, (3) patient-centred considerations, and (4) research considerations (equipoise, outcomes, and protocol suspension). Panelists were asked to score statements on a 7-point Likert scale. Consensus was established with at least 75% agreement.FindingsThe 34-member expert panel (14 of 33 women [42%]) included 16 anesthesiologists, 11 surgeons, and 7 transfusion specialists; panelists had a median of 16 years’ experience (range, 2-50 years), mainly in Canada (52% [17 of 33]), the US (27% [9 of 33]), and Europe (15% [5 of 33]). The panel recommended routine preoperative and intraoperative discussion between surgeons and anesthesiologists about intraoperative RBC transfusion as well as postoperative review of intraoperative transfusion events. Point-of-care hemoglobin testing devices were recommended for transfusion guidance, alongside an algorithmic transfusion protocol with a restrictive hemoglobin trigger; however, more research is needed to evaluate the use of restrictive triggers in the operating room. Expert consensus recommended a detailed preoperative consent discussion with patients of the risks and benefits of both anemia and RBC transfusion and routine disclosure of intraoperative transfusion. Postoperative morbidity and mortality were recommended as the most relevant outcomes associated with intraoperative RBC transfusion, and transfusion triggers of 70 and 90 g/L were considered acceptable hemoglobin triggers to evaluate restrictive and liberal transfusion strategies, respectively, in clinical trials.Conclusions and RelevanceThis consensus statement offers internationally endorsed expert guidance across several key domains on intraoperative RBC transfusion practice for noncardiac surgical procedures for which patients are at medium or high risk of bleeding. Future work should emphasize knowledge translation strategies to integrate these recommendations into routine clinical practice and transfusion research activities.

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Research Progress in Oxygen Carrier Design and Application

Ye,

Zheng,

Chen

et al. 2023

Mol. Pharmaceutics

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Ischemia or hypoxia can lead to pathological changes in the metabolism and function of tissues and then lead to various diseases. Timely and effective blood resuscitation or improvement of hypoxia is very important for the treatment of diseases. However, there is a need to develop stable, nontoxic, and immunologically inert oxygen carriers due to limitations such as blood shortages, different blood types, and the risk of transmitting infections. With the development of various technologies, oxygen carriers based on hemoglobin and perfluorocarbon have been widely studied in recent years. This paper reviews the development and application of hemoglobin and perfluorocarbon oxygen carriers. The design of oxygen carriers was analyzed, and their application as blood substitutes or oxygen carriers in various hypoxic diseases was discussed. Finally, the characteristics and future research of ideal oxygen carriers were prospected to provide reference for follow-up research.

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Blood shortages planning in Canada: The National Emergency Blood Management Committee experience during the first 6 months of the COVID‐19 pandemic

Cited by 13 publications

References 14 publications

Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

Intraoperative Blood Management Strategies for Patients Undergoing Noncardiac Surgery

Research Progress in Oxygen Carrier Design and Application

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Blood shortages planning in Canada: The National Emergency Blood Management Committee experience during the first 6 months of the COVID‐19 pandemic

Cited by 13 publications

References 14 publications

Hemoglobin–albumin clusters as an artificial O2 carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

Hemoglobin–albumin clusters as an artificial O2 carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

Intraoperative Blood Management Strategies for Patients Undergoing Noncardiac Surgery

Research Progress in Oxygen Carrier Design and Application

Contact Info

Product

Resources

About

Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats

Hemoglobin–albumin clusters as an artificial O₂ carrier: Physicochemical properties and resuscitation from hemorrhagic shock in rats