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Liu X, Li Y, Jia J, Wang H, Xi Y, Sun A, Wang L, Deng X, Chen Z, Fan Y. Analysis of non-physiological shear stress-induced red blood cell trauma across different clinical support conditions of the blood pump. Med Biol Eng Comput 2024:10.1007/s11517-024-03121-z. [PMID: 38802609 DOI: 10.1007/s11517-024-03121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/04/2024] [Indexed: 05/29/2024]
Abstract
Systematic research into device-induced red blood cell (RBC) damage beyond hemolysis, including correlations between hemolysis and RBC-derived extracellular vesicles, remains limited. This study investigated non-physiological shear stress-induced RBC damage and changes in related biochemical indicators under two blood pump clinical support conditions. Pressure heads of 100 and 350 mmHg, numerical simulation methods, and two in vitro loops were utilized to analyze the shear stress and changes in RBC morphology, hemolysis, biochemistry, metabolism, and oxidative stress. The blood pump created higher shear stress in the 350-mmHg condition than in the 100-mmHg condition. With prolonged blood pump operation, plasma-free hemoglobin and cholesterol increased, whereas plasma glucose and nitric oxide decreased in both loops. Notably, plasma iron and triglyceride concentrations increased only in the 350-mmHg condition. The RBC count and morphology, plasma lactic dehydrogenase, and oxidative stress across loops did not differ significantly. Plasma extracellular vesicles, including RBC-derived microparticles, increased significantly at 600 min in both loops. Hemolysis correlated with plasma triglyceride, cholesterol, glucose, and nitric oxide levels. Shear stress, but not oxidative stress, was the main cause of RBC damage. Hemolysis alone inadequately reflects overall blood pump-induced RBC damage, suggesting the need for additional biomarkers for comprehensive assessments.
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Affiliation(s)
- Xinyu Liu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Yuan Li
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Jinze Jia
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Hongyu Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Yifeng Xi
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Anqiang Sun
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Xiaoyan Deng
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Zengsheng Chen
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China.
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Room 223, Building 5, No.37 Xueyuan Road, Haidian District, Beijing, 100083, China.
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Wang CY, Li XL, Ma XL, Yang XF, Liu YY, Yu YJ. Preoperative neutrophil-to-lymphocyte ratio predicts symptomatic anastomotic leakage in elderly colon cancer patients: Multicenter propensity score-matched analysis. World J Gastrointest Surg 2024; 16:438-450. [PMID: 38463372 PMCID: PMC10921198 DOI: 10.4240/wjgs.v16.i2.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/18/2023] [Accepted: 01/15/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR), a composite inflammatory biomarker, is associated with the prognosis in patients with colorectal tumors. However, whether the NLR can be used as a predictor of symptomatic postoperative anastomotic leakage (AL) in elderly patients with colon cancer is unclear. AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer. METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed. Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR. Twenty-two covariates were matched using a 1:1 propensity score matching method, and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL. RESULTS Of the 577 patients included, 36 (6.2%) had symptomatic AL. The optimal cutoff value of the NLR for predicting AL was 2.66. After propensity score matching, the incidence of AL was significantly greater in the ≥ 2.66 NLR subgroup than in the < 2.66 NLR subgroup (11.5% vs 2.5%; P = 0.012). Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoperatively, preoperative albumin concentration, preoperative prognostic nutritional index, and preoperative NLR and AL occurrence (P < 0.05); multivariate logistic regression analysis revealed that an NLR ≥ 2.66 [odds ratio (OR) = 5.51; 95% confidence interval (CI): 1.50-20.26; P = 0.010] and blood transfusion intraoperatively and within 2 d postoperatively (OR = 2.52; 95%CI: 0.88-7.25; P = 0.049) were risk factors for the occurrence of symptomatic AL. CONCLUSION A preoperative NLR ≥ 2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer. The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.
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Affiliation(s)
- Chao-Yang Wang
- Department of Clinical Medicine, The First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Xiao-Long Li
- Department of Gastrointestinal Surgery, First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Xiao-Long Ma
- Department of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
| | - Xiong-Fei Yang
- Department of Anorectology, Gansu Provincial People’s Hospital, Lanzhou 730000, Gansu Province, China
| | - Yong-Yong Liu
- Department of General Surgery, The Second Hospital Affiliated to Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yong-Jiang Yu
- Department of Gastrointestinal Surgery, First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
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Barshtein G, Pajic-Lijakovic I, Gural A. Deformability of Stored Red Blood Cells. Front Physiol 2021; 12:722896. [PMID: 34690797 PMCID: PMC8530101 DOI: 10.3389/fphys.2021.722896] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022] Open
Abstract
Red blood cells (RBCs) deformability refers to the cells’ ability to adapt their shape to the dynamically changing flow conditions so as to minimize their resistance to flow. The high red cell deformability enables it to pass through small blood vessels and significantly determines erythrocyte survival. Under normal physiological states, the RBCs are attuned to allow for adequate blood flow. However, rigid erythrocytes can disrupt the perfusion of peripheral tissues and directly block microvessels. Therefore, RBC deformability has been recognized as a sensitive indicator of RBC functionality. The loss of deformability, which a change in the cell shape can cause, modification of cell membrane or a shift in cytosol composition, can occur due to various pathological conditions or as a part of normal RBC aging (in vitro or in vivo). However, despite extensive research, we still do not fully understand the processes leading to increased cell rigidity under cold storage conditions in a blood bank (in vitro aging), In the present review, we discuss publications that examined the effect of RBCs’ cold storage on their deformability and the biological mechanisms governing this change. We first discuss the change in the deformability of cells during their cold storage. After that, we consider storage-related alterations in RBCs features, which can lead to impaired cell deformation. Finally, we attempt to trace a causal relationship between the observed phenomena and offer recommendations for improving the functionality of stored cells.
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Affiliation(s)
- Gregory Barshtein
- Biochemistry Department, The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Alexander Gural
- Department of Hematology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Yarnoff K, Dodd-O JM. Mixing commonly used crystalloid solutions with red blood cells in five common additives does not negatively impact hemolysis, aggregometry, or deformability. Transfusion 2020; 60:2991-3000. [PMID: 33032376 DOI: 10.1111/trf.16089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Literature is beginning to challenge the belief that it is unsafe to coinfuse red blood cells (RBCs) with solutions other than isotonic saline. We recently showed that additive-free RBCs tolerated coincubation with Plasma-Lyte or catecholamines dissolved in normal saline (NS), though 5% dextrose in water (D5W) promoted hemolysis. Herein, we evaluate the effect of coincubating crystalloids on additive-preserved RBC hemolysis, aggregation, and membrane deformability. STUDY DESIGN AND METHODS RBCs were coincubated 5 minutes with plasma, NS, Plasma-Lyte, lactated Ringer's (LR) or D5W (1 mL PRBC +131.3 μL solution). Samples were then assessed for hemolysis (free hemoglobin), aggregation (critical shear stress [mPa]), and membrane deformability (elongation index [EI]). Significance (P ≤ .05) by t test or ANOVA with post-hoc Tukey-Kramer test. RESULTS Additive-prepared RBCs coincubated with crystalloid instead of plasma demonstrated: (a) no increase in hemolysis as indicated by plasma free hemoglobin levels that is likely to be clinically relevant; (b) no increase, but in some cases a decrease, in aggregation as indicated by critical shear stress; and (c) in some combinations, a deterioration in deformability. When present, the deformability decrease was likely clinically insignificant in degree, and always returned to normal when the crystalloid was subsequently diluted out with plasma. CONCLUSION Our data suggest that additive-prepared RBCs coincubated for 5 minutes with any of four common crystalloids demonstrate no clinically relevant increased lysis, increased aggregation, or decreased deformability.
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Affiliation(s)
- Kristine Yarnoff
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeffrey M Dodd-O
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Meng Q, Peng X, Zhao S, Xu T, Wang S, Liu Q, Cai R, Fan Y. Hypoxic storage of erythrocytes slows down storage lesions and prolongs shelf-life. J Cell Physiol 2019; 234:22833-22844. [PMID: 31264213 DOI: 10.1002/jcp.28847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/03/2019] [Indexed: 01/28/2023]
Abstract
Conventional storage conditions of erythrocytes cause storage lesions. We propose that hypoxic storage conditions, involving removal of oxygen and replacement with helium, the changes in stored erythrocytes under hypoxic condition were observed and assessed. Erythrocytes were divided into two equal parts, then stored in conventional and hypoxic conditions, separately. Blood gas analysis, hemorheology, and hemolysis were performed once a week. Energy metabolism and membrane damage were monitored by enzyme-linked immunosorbent assay. Phosphatidylserine exposure was measured by flow cytometry. P50 was measured and the oxygen dissociation curve (ODC) plotted accordingly. Erythrocyte morphology was observed microscopically. In the 9th week of storage, the hemolysis of the hypoxia group was 0.7%; lower (p < .05) than that of the control group and still below the threshold of quality requirements. The dissolved oxygen and pO2 were only 1/4 of that in the control group (p < .01); the adenosine triphosphate, glucose, and lactic acid levels were decreased (p < .05), while the 2,3-diphosphoglycerate levels were increased relative to that in the control group (p < .01). There were no statistically significant differences in membrane damage, deformability, and aggregation between the two groups. In addition, the ODC of the two groups was shifted to the left but this difference was not statistically different. Basically similar to the effect of completely anaerobic conditions. Erythrocytes stored under hypoxic conditions could maintain a relatively stable state with a significant decrease in hemolysis, reduction of storage lesions, and an increase in shelf-life.
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Affiliation(s)
- Qiang Meng
- Department of Transfusion Medicine, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.,Department of Laboratory Medicine and Blood Transfusion, Guiqian International General Hospital, Guiyang, China
| | - Xiaowu Peng
- Department of Laboratory Medicine, Wulongbei Healing Area of Dalian Rehabilitation Center, Dandong, China
| | - Shuming Zhao
- Department of Laboratory Medicine and Blood Transfusion, Guiqian International General Hospital, Guiyang, China
| | - Ting Xu
- Department of Transfusion Medicine, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shichun Wang
- Department of Transfusion Medicine, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qi Liu
- Department of Transfusion Medicine, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ruili Cai
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yahan Fan
- Department of Transfusion Medicine, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Sharma S. Role of redox iron towards an increase in mortality among patients: a systemic review and meta-analysis. Blood Res 2019; 54:87-101. [PMID: 31309086 PMCID: PMC6614104 DOI: 10.5045/br.2019.54.2.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 11/25/2022] Open
Abstract
An increase in biochemical concentrations of non-transferrin bound iron (NTBI) within the patients with an increase in serum iron concentration was evaluated with the following objectives: (a) Iron overloading diseases/conditions with free radicle form of ‘iron containing’ reactive oxygen species (ROS) and its imbalance mediated mortality, and (b) Intervention with iron containing drugs in context to increased redox iron concentration and treatment induced mortality. Literature search was done within Pubmed and cochrane review articles. The Redox iron levels are increased during dys-erythropoiesis and among transfusion recipient population and are responsive to iron-chelation therapy. Near expiry ‘stored blood units’ show a significant rise in the ROS level. Iron mediated ROS damage may be estimated by the serum antioxidant level, and show reduction in toxicity with high antioxidant, low pro-oxidant levels. Iron drug therapy causes a significant increase in NTBI and labile iron levels. Hospitalized patients on iron therapy however show a lower mortality rate. Serum ferritin is a mortality indicator among the high-dose iron therapy and transfusion dependent population. The cumulative difference of pre-chelation to post chelation ROS iron level was 0.97 (0.62; 1.32; N=261) among the transfusion dependent subjects and 2.89 (1.81–3.98; N=130) in the post iron therapy ‘iron ROS’ group. In conclusion, iron mediated mortality may not be mediated by redox iron among multi-transfused and iron overloaded patients.
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Affiliation(s)
- Sankalp Sharma
- Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences Raipur, Chhattisgarh, India
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7
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Mladinov D, Yarnoff K, Nagababu E, Berkowitz DE, Lawrence C, Ness PM, Kickler T, Brunker PA, Boyd JS, Dodd-O JM. Effect of incubation with crystalloid solutions or medications on packed red blood cells. Transfusion 2019; 59:2643-2651. [PMID: 31135973 DOI: 10.1111/trf.15353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND American Association of Blood Banks (AABB) guidelines suggest that packed red blood cells (PRBCs) be administered through a dedicated intravenous (IV) catheter. Literature supporting this broad-scope declaration are scarce. Obtaining additional IV access is painful, costly, and an infectious risk. We evaluated the effect of co-incubating PRBCs with crystalloids and medications on PRBC hemolysis, membrane deformability, and aggregation, as well as medication concentration. METHODS PRBCs were co-incubated 5 minutes with plasma, normal saline (NS), 5% dextrose in water (D5W), Plasmalyte, epinephrine (epi), norepinephrine (norepi), dopamine (dopa), or Propofol (prop). Samples were then assessed for hemolysis (free hemoglobin, serum potassium), membrane deformability (elongation index [EI]), aggregation (smear, critical shear stress [mPa]) and drug concentration (High Performance Liquid Chromatography/Tandem Mass Spectrometry [LCMS-MS]). Significance (p ≤ 0.05) was determined by Wilcoxon-paired comparisons or Wilcoxon/Kruskall Willis with post-hoc Dunn's test. RESULTS Compared to co-incubation with plasma: 1) co-incubation resulted in significantly increased hemolysis only when D5W as used (free hemoglobin, increased potassium); 2) EI trended lower when co-incubated with D5W and trended toward higher when co-incubated with prop; 3) aggregation was significantly lower when PRBCs co-incubated with NS, D5W, or Plasmalyte, and trended lower when co-incubated with epi, norepi, or dopa. Medication concentrations were between those predicted by distribution only in plasma and distribution through the entire intra- and extracellular space. CONCLUSION Our data suggest that 5 minutes of PRBC incubation with isotonic crystalloids or catecholamines does not deleteriously alter PRBC hemolysis, membrane deformability, or aggregation. Co-incubation with D5W likely increases hemolysis. Propofol may promote hemolysis.
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Affiliation(s)
- Domagoj Mladinov
- Department of Anesthesiology, University of Alabama, Birmingham, Alabama
| | - Kristine Yarnoff
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Enika Nagababu
- Department of Anesthesiology, University of Alabama, Birmingham, Alabama
| | - Daniel E Berkowitz
- Department of Anesthesiology, University of Alabama, Birmingham, Alabama
| | - Courtney Lawrence
- Department of Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paul M Ness
- Department of Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas Kickler
- Department of Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A Brunker
- Department of Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Joan S Boyd
- Department of Transfusion Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeffrey M Dodd-O
- Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Kristof K, Büttner B, Grimm A, Mewes C, Schmack B, Popov AF, Ghadimi M, Beissbarth T, Hinz J, Bergmann I, Mansur A. Anaemia requiring red blood cell transfusion is associated with unfavourable 90-day survival in surgical patients with sepsis. BMC Res Notes 2018; 11:879. [PMID: 30537993 PMCID: PMC6290543 DOI: 10.1186/s13104-018-3988-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/05/2018] [Indexed: 12/26/2022] Open
Abstract
Objective The mortality associated with sepsis remains unacceptably high, despite modern high-quality intensive care. Based on the results from previous studies, anaemia and its management in patients with sepsis appear to impact outcomes; however, the transfusion policy is still being debated, and the ideal approach may be extremely specific to the individual. This study aimed to investigate the long-term impact of anaemia requiring red blood cell (RBC) transfusion on mortality and disease severity in patients with sepsis. We studied a general surgical intensive care unit (ICU) population, excluding cardiac surgery patients. 435 patients were enrolled in this observational study between 2012 and 2016. Results Patients who received RBC transfusion between 28 days before and 28 days after the development of sepsis (n = 302) exhibited a significantly higher 90-day mortality rate (34.1% vs 19.6%; P = 0.004, Kaplan–Meier analysis). This association remained significant after adjusting for confounders in the multivariate Cox regression analysis (hazard ratio 1.68; 95% confidence interval 1.03–2.73; P = 0.035). Patients who received transfusions also showed significantly higher morbidity scores, such as SOFA scores, and ICU lengths of stay compared to patients without transfusions (n = 133). Our results indicate that anaemia and RBC transfusion are associated with unfavourable outcomes in patients with sepsis. Electronic supplementary material The online version of this article (10.1186/s13104-018-3988-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katalin Kristof
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Benedikt Büttner
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Anna Grimm
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Caspar Mewes
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Bastian Schmack
- Department of Cardiac Surgery, University Hospital, Ruprecht Karls University, Heidelberg, Germany
| | - Aron Frederik Popov
- Department of Thoracic and Cardiovascular Surgery, University Medical Center, Goethe University, Frankfurt, Germany
| | - Michael Ghadimi
- Department of General, Visceral and Pediatric Surgery, University Medical Center, Georg August University, Goettingen, Germany
| | - Tim Beissbarth
- Department of Medical Statistics, University Medical Center, Georg August University, Goettingen, Germany
| | - José Hinz
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Ingo Bergmann
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany
| | - Ashham Mansur
- Department of Anesthesiology, University Medical Center, Georg August University, Goettingen, Germany.
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Neutrophil extracellular traps were released during intraoperative blood salvage in posterior lumbar surgery. Transfus Apher Sci 2018; 57:259-264. [DOI: 10.1016/j.transci.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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10
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Zhang J, Wang Y, You GX, Wang Q, Zhang S, Yu WL, Hu T, Zhao L, Zhou H. Conjugation with 20 kDa dextran decreases the autoxidation rate of bovine hemoglobin. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2017; 46:1436-1443. [DOI: 10.1080/21691401.2017.1371184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jun Zhang
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Ying Wang
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Guo-Xing You
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Quan Wang
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Shan Zhang
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Wei-Li Yu
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, China
| | - Tao Hu
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, China
| | - Lian Zhao
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
| | - Hong Zhou
- Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China
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11
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Huyut Z, Şekeroğlu MR, Balahoroğlu R, Huyut MT. Characteristics of resveratrol and serotonin on antioxidant capacity and susceptibility to oxidation of red blood cells in stored human blood in a time-dependent manner. J Int Med Res 2017; 46:272-283. [PMID: 28835147 PMCID: PMC6011276 DOI: 10.1177/0300060517725450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective In stored red blood cells (RBCs), which are used in diseases (e.g., acute blood loss and leukaemia), storage lesions arise by oxidative stress and other factors over time. This study investigated the protective effects of resveratrol and serotonin on stored RBCs. Methods Blood from each donor (n = 10) was placed in different bags containing 70 mL of citrate phosphate dextrose (total volume: 500 mL) and divided into three groups (n = 30): control, 60 µg/mL resveratrol, and 60 µg/mL serotonin. Malondialdehyde (MDA) and glutathione (GSH) levels, activity of glutathione peroxidase (GSH-Px), catalase, and carbonic anhydrase (CA), and susceptibility to oxidation in RBCs, and pH in whole blood were measured at baseline and on days 7, 14, 21, and 28. Results MDA levels and susceptibility to oxidation were increased in all three groups time-dependently, but this increase was greater in the serotonin group than in the other groups. Activity of GSH-Px, CAT, and CA, as well as GSH levels, were decreased in the control and serotonin groups time-dependently, but were significantly preserved in the resveratrol group. The pH was decreased in all groups time-dependently. Conclusion Our study shows that resveratrol attenuates susceptibility to oxidation of RBCs and protects their antioxidant capacity, and partially preserves CA activity time-dependently.
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Affiliation(s)
- Zübeyir Huyut
- 1 Department of Biochemistry, Medical Faculty, 64162 Yuzuncu Yıl University , Van, Turkey
| | | | - Ragıp Balahoroğlu
- 3 Department of Biochemistry, Region Research Hospital, Konya, Turkey
| | - Mehmet Tahir Huyut
- 4 Department of Biostatistics, Medical Faculty, 64162 Yuzuncu Yıl University , Van, Turkey
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12
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Kozlova E, Chernysh A, Moroz V, Sergunova V, Gudkova O, Manchenko E. Morphology, membrane nanostructure and stiffness for quality assessment of packed red blood cells. Sci Rep 2017; 7:7846. [PMID: 28798476 PMCID: PMC5552796 DOI: 10.1038/s41598-017-08255-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/07/2017] [Indexed: 02/07/2023] Open
Abstract
Transfusion of packed red blood cells (PRBC) to patients in critical states is often accompanied by post-transfusion complications. This may be related with disturbance of properties of PRBC and their membranes during long-term storage in the hemopreservative solution. The purpose of our work is the study of transformation of morphology, membranes stiffness and nanostructure for assessment of PRBC quality, in vitro. By atomic force microscopy we studied the transformation of cell morphology, the appearance of topological nanodefects of membranes and by atomic force spectroscopy studied the change of membrane stiffness during 40 days of storage of PRBC. It was shown that there is a transition period (20–26 days), in which we observed an increase in the Young’s modulus of the membranes 1.6–2 times and transition of cells into irreversible forms. This process was preceded by the appearance of topological nanodefects of membranes. These parameters can be used for quality assessment of PRBC and for improvement of transfusion rules.
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Affiliation(s)
- E Kozlova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation. .,Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow StateMedical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - A Chernysh
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation.,Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow StateMedical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - V Moroz
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - V Sergunova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - O Gudkova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
| | - E Manchenko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Scientific Research Institute of General Reanimatology, Moscow, Russian Federation
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13
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D'Alessandro A, Gray AD, Szczepiorkowski ZM, Hansen K, Herschel LH, Dumont LJ. Red blood cell metabolic responses to refrigerated storage, rejuvenation, and frozen storage. Transfusion 2017; 57:1019-1030. [PMID: 28295356 DOI: 10.1111/trf.14034] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/10/2016] [Accepted: 12/19/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Storage of red blood cells (RBCs) under blood bank conditions promotes metabolic modulation within the RBC. This "metabolic storage lesion" may affect the quality and safety of the transfused RBCs. The aim of this study is to determine the metabolic changes in stored RBCs over 42 days of routine storage followed by a US Food and Drug Administration-approved method of rejuvenation, freezing, and preparation for transfusion. STUDY DESIGN AND METHODS We exploited a mass spectrometry-based metabolomics approach to monitor 42-day-stored citrate phosphate dextrose/AS-1 RBCs (n = 29) that were rejuvenated, glycerolized and frozen, then thawed and deglycerolized, and held for 24 hours at 1 to 6ºC in saline-glucose. RESULTS Previously reported metabolic alterations were confirmed in 42-day-old RBCs. In this study, in total, 181 (62%) of the biochemical compounds exhibited significant (p ≤ 0.05) change compared with Day 0 values. Rejuvenation restored adenosine triphosphate and 2,3-diphosphoglycerate levels, replenished purine reservoirs, up regulated glycolysis, increased levels of pentose phosphate pathway intermediates, and partially rescued glutathione biosynthesis. Increased levels of lysophospholipid in rejuvenated RBCs suggests the activation of recycling pathways of damaged membrane lipids, in which a total of 167 (57%) biochemical compounds showed significant change compared with Day 42 values. CONCLUSION Rejuvenation reversed over one-half of the metabolic biochemical compounds evaluated compared with Day 42 values, and the compounds were stable through frozen storage and preparation for transfusion. Rejuvenation promoted significant metabolic reprogramming, including the reactivation of energy-generating and antioxidant pathways (the pentose phosphate pathway and glutathione homeostasis), salvage reactions, cofactor reservoirs, and membrane lipid recycling.
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Affiliation(s)
- Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
| | | | - Zbigniew M Szczepiorkowski
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.,Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Kirk Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado
| | | | - Larry J Dumont
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
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14
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Terp Fjederholt K, Svendsen LB, Mortensen FV. Perioperative blood transfusions increases the risk of anastomotic leakage after surgery for GEJ-cancer. Am J Surg 2017; 214:293-298. [PMID: 28259203 DOI: 10.1016/j.amjsurg.2017.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/11/2017] [Accepted: 01/19/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effect of blood transfusions on the risk of anastomotic leakage (AL) in patients with gastro-esophageal-junction (GEJ) cancer. BACKGROUND The incidence of GEJ cancer is increasing in the western world. Surgery is the curative treatment of choice. AL increases mortality and morbidity, and increases the risk cancer reoccurrence. In colo-rectal surgery a relation between AL and blood transfusions have been demonstrated. METHOD The risk of AL in relation to blood transfusions was investigated in a cohort study. 253 consecutive patients undergoing surgery for GEJ cancer was included. Data was based on a prospective maintained database and analyzed using logistic regressions models adjusting for multiple confounders. RESULTS We found an increased risk of AL when blood was transfused OR: 3.47, (1.51; 7.99). This relation was consistent after adjustment for multiple confounders OR: 4.60, (1.29; 16.4). Increasing number of blood units did not increase risk of AL further. CONCLUSION We present data demonstrating a strong correlation between receiving blood transfusions and the risk of AL after surgery in GEJ cancers patients.
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Affiliation(s)
- Kaare Terp Fjederholt
- Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Denmark.
| | - Lars Bo Svendsen
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Denmark
| | - Frank Viborg Mortensen
- Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Denmark
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15
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Emelianov VV, Leontev DV, Ishchenko AV, Bulavintseva TS, Savateeva EA, Danilova IG. Atomic-force microscopy of erythrocytes and metabolic disorders in experimental diabetes mellitus and during the correction of diabetes with lipoic acid. Biophysics (Nagoya-shi) 2016. [DOI: 10.1134/s0006350916050067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Antonelou MH, Seghatchian J. Insights into red blood cell storage lesion: Toward a new appreciation. Transfus Apher Sci 2016; 55:292-301. [PMID: 27839967 DOI: 10.1016/j.transci.2016.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Red blood cell storage lesion (RSL) is a multifaceted biological phenomenon. It refers to deterioration in RBC quality that is characterized by lethal and sub-lethal, reversible and irreversible defects. RSL is influenced by prestorage variables and it might be associated with variable clinical outcomes. Optimal biopreservation conditions are expected to offer maximum levels of RBC survival and acceptable functionality and bioreactivity in-bag and in vivo; consequently, full appraisal of RSL requires understanding of how RSL changes interact with each other and with the recipient. Recent technological innovation in MS-based omics, imaging, cytometry, small particle and systems biology has offered better understanding of RSL contributing factors and effects. A number of elegant in vivo and in vitro studies have paved the way for the identification of quality control biomarkers useful to predict RSL profile and posttransfusion performance. Moreover, screening tools for the early detection of good or poor "storers" and donors have been developed. In the light of new perspectives, storage time is not the touchstone to rule on the quality of a packed RBC unit. At least by a biochemical standpoint, the metabolic aging pattern during storage may not correspond to the currently fresh/old distinction of stored RBCs. Finally, although each unit of RBCs is probably unique, a metabolic signature of RSL across storage variables might exist. Moving forward from traditional hematologic measures to integrated information on structure, composition, biochemistry and interactions collected in bag and in vivo will allow identification of points for intervention in a transfusion meaningful context.
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Affiliation(s)
- Marianna H Antonelou
- Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
| | - Jerard Seghatchian
- International Consultancy in Blood Component Quality/Safety Improvement, Audit/Inspection and DDR Strategy, London, UK.
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