Clinical implications of red blood cell and platelet storage lesions: an overview

Solheim, Bjarte G.; Flesland, Øystein; Seghatchian, Jerard; Brosstad, Frank

doi:10.1016/j.transci.2004.09.004

Cited by 39 publications

(42 citation statements)

References 26 publications

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“…This apparent contradiction might be explained by the additional increase in FSVD 24 h after the transfusion without change in hematocrit. We know from animal studies that storage of RBCs leads to biochemical and physical changes that hinder their function during transfusion (22)(23)(24) and decrease functional capillary density (25). For the depleted RBC 2,3-diphosphateglycerate acid (2, 3 DPG) and ATP concentrations at least one day is required until 50 to 70% of the normal level of 2,3 DPG is recovered and 1 wk for full recovery.…”

Section: Discussionmentioning

confidence: 99%

Functional Vessel Density in the First Month of Life in Preterm Neonates

Kroth¹,

Weidlich

Hiedl³

et al. 2008

Pediatr Res

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Changes in microcirculation have been recognized as central to many disease processes. The aim of this study was to evaluate factors, which influence the microcirculation of the skin during the first month of life in premature infants. Red blood cell (RBC) velocity, vessel diameter, and functional small vessel density (FSVD) were measured daily for the first 30 d on the upper arm in preterm infants with gestational age Ͻ30 wk. Orthogonal polarization spectral (OPS) images were analyzed off-line with the CapiScope-Image program. In 25 infants, FSVD decreased significantly from week 1 (mean Ϯ SD 236 Ϯ 33 cm/cm 2 ) to week 4 (207 Ϯ 30 cm/cm 2 ) and correlated directly with Hb levels and incubator temperature. Vessel diameters and RBC velocity did not change significantly, nor did clinical parameters such as blood pressure, heart rate or body temperature. Microvascular parameters were not dependent on gestational or postnatal age. The microcirculation of the skin might be an easily accessible window to obtain better understanding of circulatory changes in the postnatal period. Our data are essential as basis for further studies in this field. Hb levels and possible incubator temperatures have a substantial influence on functional small vessel density and therefore need to be taken in account. D isturbances of the microcirculation play a key role in many disease states (1-4). The recent development of new technologies has helped to investigate these changes in adult patients with sepsis (5-7). Previous studies have shown that parameters of microcirculation such as microvessel diameter, red blood cell velocity, and functional small vessel density (FSVD) can be measured in the skin of term and preterm infants by Orthogonal Polarization Spectral (OPS) imaging in the first week of life (8) and that FSVD increases after elective blood transfusion in anemic neonates (9). The microcirculation of the skin plays an important role in maintaining a constant body temperature and in regulating the fluid balance (10,11). Adequate function of the microcirculation is a prerequisite for tissue nutrition and oxygen supply (12). The microcirculation of the skin in neonates differs in several aspects from that of an adult. The regular architecture has been found to be poorly developed in the newborn (13). At birth, the skin shows a disorderly capillary network and no papillary loops in almost all areas, except the palms, soles, and nail folds. The skin is richly supplied by a dense subepidermal plexus demonstrating relatively little regional variation (14).Functional capillary density (FCD) is one of the parameters that delineate the microcirculation. FCD is defined as the length of red cell-perfused capillaries per observation area and is given as cm/cm 2 . FCD has been used as an indicator of the quality of tissue perfusion (15). In neonates capillary vessels, arterioles, and venules cannot clearly be differentiated in the OPS images, so that the expression FSVD is used.The aim of the study was to determine whether tissue pe...

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Section: Discussionmentioning

confidence: 99%

Functional Vessel Density in the First Month of Life in Preterm Neonates

Kroth¹,

Weidlich

Hiedl³

et al. 2008

Pediatr Res

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“…These latter acoustic studies confirmed that this sudden, small ''thrust'' occurred at the precise moment of serum expulsion. Note that the time apparition of such G 00 modal increase at t e could be affected by the initial blood composition, by the age of the sample (Solheim et al, 2004;Uyuklu et al, 2009) or by chemical interactions between the agar-gelatin block surface of the phantom and the blood sample.…”

Section: Viscoelasticity Evolution During Blood Coagulationmentioning

confidence: 99%

Characterization of blood clot viscoelasticity by dynamic ultrasound elastography and modeling of the rheological behavior

Schmitt

Henni

Cloutier

2011

Journal of Biomechanics

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“…Storage at +4 °C for several days may reduce the risk of spirochetes, some cell-associated viruses and mononuclear cells responsible for GvHD (Sakakibara & Juji, 1986). Whereas no claim has been made that RBC quality improves during storage beyond the first few days, an abundance of in vitro evidence implicates refrigerated storage as increasingly detrimental to RBC quality (Chin-Yee et al , 1997; Tinmouth & Chin-Yee, 2001; Solheim et al , 2004). …”

Section: Introductionmentioning

confidence: 99%

Does prolonged storage of red blood cells cause harm?

2014

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Summary Red blood cells (RBCs) degrade progressively during the weeks of refrigerated storage. No universally accepted definition of “fresh” or “old” RBCs exists. While practices vary from country to country, preservative solutions permitting shelf life as long as 7 weeks have been licensed. Transfusion of stored RBCs, particularly those at the end of the approved shelf life, has been implicated in adverse clinical outcomes. The results of observational analyses, animal models and studies in volunteers have proved provocative, controversial and contradictory. A recently completed randomized controlled trial (RCT) in premature infants exemplifies the difficulties with moderately sized clinical studies. Several other RCTs are in progress. The effect of RBC storage may well vary according to the clinical setting. Resolution of the importance of the storage lesion may require large pragmatic clinical trials. In the meantime, institutions involved in blood collection and transfusion should explore strategies that assure blood availability, while limiting the use of the oldest RBCs currently approved by regulation.

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Clinical implications of red blood cell and platelet storage lesions: an overview

Cited by 39 publications

References 26 publications

Functional Vessel Density in the First Month of Life in Preterm Neonates

Functional Vessel Density in the First Month of Life in Preterm Neonates

Characterization of blood clot viscoelasticity by dynamic ultrasound elastography and modeling of the rheological behavior

Does prolonged storage of red blood cells cause harm?

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