Patient safety and blood transfusion: new solutions.
Interesting paper on new solutions for making transfusions safer. The only aspect which is missing is a better education of the staff involved in hemotherapy, which is even more important than monitoring, etc. – Volker Kretschmer
Perflubron emulsion in prolonged hemorrhagic shock: influence on hepatocellular energy metabolism and oxygen-dependent gene expression.
This experimental study, using quite sophisticated methods, demonstrates that a perfluorocarbon emulsion together with a high FiO2 is able to improve oxygen availability to the liver as compared to stored whole blood or colloids during prolonged hemorrhagic shock. This is another contribution to the increased evidence that, like hemoglobin solutions, perfluorocarbon solutions are not blood […]
A mathematical model of cell salvage efficiency.
In this excellent paper, the authors develop a mathematical model that may help our understanding of the efficiency of blood salvage. The basic insights from these theoretical considerations are that we should make all efforts to increase RBC recovery from the surgical field and use smaller bowls for low-weight and low-hematocrit patients. Difficulties in translating […]
Recombinant human transgenic antithrombin in cardiac surgery: a dose-finding study.
This is a very important paper in two ways. First, it highlights ongoing activation of hemostasis in the postoperative period as demonstrated by the control group. The scale of Figure 1 blurs the very low activity in patients with or without a low dose of antithrombin (AT). This period of activation may even exist longer […]
Platelet transfusions in children: results of a randomized, prospective, crossover trial of plasma removal and a prospective audit of WBC reduction.
Disappointing and rather surprising results. The lower incidence of transfusion reactions (TR) in children is not surprising since the referred frequency of TR in adults (up to 37% from literature) is notin line with the reality. – V. Kretschmer
Clinical significance of RBC alloantibodies and autoantibodies in sickle cell patients who received transfusions.
The study shows that transfusion of blood matched for Rh and Kell systems would reduce alloimmunization to 27% and reduce delayed hemolytic transfusion reaction, but would not prevent it. Delayed hemolytic transfusion reactions were mild and did not cause hyperhemolysis in sickle cell patients. However, the cause of hyperhemolysis, which is a severe problem, was […]
Are lactated Ringer’s solution and normal saline solution equal with regard to coagulation?
This study compares the perioperative effects of a saline crystalloid and a more balanced and buffered electrolyte crystalloid on clotting. The differences thought to be related to blood clotting that one would anticipate in such a study would that the saline treated patients would become more acidotic and have lower ionized calcium. Therefore, in interpreting […]
A double-blind study to evaluate the safety of recombinant human hemoglobin in surgical patients during general anesthesia.
The authors evaluated the safety profile of escalating doses of rHb1.1 in patients undergoing surgery under general anesthesia. The adverse effects observed (and the authors’ conclusions) are those that one would expect for this type of product. Unfortunately, it appears that we have not yet found the Holy Grail of hemoglobin replacement therapy… – J.-F. […]
Amplification of the DNA polymerase I gene of Treponema pallidum from whole blood of persons with syphilis.
The article confirms by means of the sensitive PCR technique that Treponema pallidum may be found in blood during the whole course of syphilis infection. – V. Kretschmer.
The effects of hemoglobin glutamer-200 (Bovine) on the microcirculation in a canine hypovolemia model: A noninvasive computer-assisted intravital microscopy study.
The authors present a dog model of hemorrhage (similar to 40% blood loss) that will be useful for the evaluation of treatment(s) of severe hypovolemia. In this case, hemoglobin glutamer-200 was used to restore the circulating blood volume and oxygen carrying capacity. However, the authors’ conclusions are limited by the small number of dogs studied […]
Prospective RBC phenotype matching in a stroke-prevention trial in sickle cell anemia: a multicenter transfusion trial.
For a transfusionist from West/North Europe, the results are predictable and the conclusion expectable. In Germany, the prospective RBC phenotype matching in sickle cell anemia and thalassemia, and even in patients with chronic anemia, has been performed for many years (at least for C, c, E, e, K) and does not pose major problems. It […]
High intensity focused ultrasound: A method of hemostasis.
This inovative work bears watching. Potential applications include minimally invasive, i.e., laparoscopic, approaches to control of traumatic liver injury. – R. K. Spence.
