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Modern haemotherapy is equivalent to restrictive use of blood components. Therefore, transfusion of whole blood in homologous transfusion generally cannot be accepted. In autologous blood transfusion blood components also are preferable if they can be separated appropriately. In order to have broad application of preoperative autologous blood deposits, close cooperation to transfusion services should be established guaranteeing optimal production of blood components. If this cooperation is impossible there are no objections against the use of autologous whole blood as long as the expected blood consumption is less than 3 red cell units. Additionally, in this case storage of more than 3 weeks mostly is not necessary. The fact that whole blood is not further part of the 'Monographien' of the Federal Health Administration (BGA) does not forbid the use of autologous whole blood since the 'Monographien' only concern generally available homologous blood components.
BACKGROUND: Shed nonwashed blood and shed washed red blood cells (RBC) are being used as alternatives to allogeneic liquid-preserved RBC for patients during thoracic and cardiovascular surgical procedures. METHODS: Mongrel dogs were bled a volume of blood into the abdominal cavity and the shed blood was reinfused as nonwashed blood or washed RBC. The 51Cr RBC volumes were measured before, immediately after, and 24 hours after the exchange transfusion to assess the recovery of the shed RBC and the 24-hour posttransfusion survival. Compatible dogs were given allogeneic transfusions of 51Cr-labeled nonwashed blood and washed RBC, and 24-hour posttransfusion survival and half-life were measured. RESULTS: Immediately after the 100% exchange transfusion, the recovery value was 62% for the nonwashed shed blood and 82% for the washed RBC. Both the nonwashed blood and the washed RBC had 24-hour posttransfusion survival values of 90% and normal oxygen transport function after the exchange transfusion. Compatible allogeneic 51Cr-labeled nonwashed blood and washed RBC had normal 24-hour posttranfusion survival and 51Cr half-life values. CONCLUSIONS: The survival, function, and hemolysis of shed nonwashed blood and shed washed RBC were similar to fresh blood in the dog that underwent a 100% exchange transfusion.
This study was undertaken to provide more information on the lymphocytic reaction to blood loss in the peripheral blood of healthy blood donors. Number of lymphocytes as well as lymphocytic nucleolar coefficient and number of lymphocytes classified according to the presence of functionally dominant nucleoli in their nuclei were studied 10 minutes, 2 and 24 hours, 2, 4, 6, and 8 weeks after blood donation. In general, the number of these cells increased rapidly after blood donation reaching maximal values of 2-24 hours, then it slowly returned to the original values after 4-8 weeks depending on the functionally dominant nucleolar type in their nuclei. According to the presented results the lymphocytic reaction may also differ in new and repeated blood donors as well as in various seasons of the year. In contrast, no differences were observed between male and female blood donors after the first blood donation in one and the same season of the year. The values of the lymphocytic nucleolar coefficient increased after blood donation and were usually different in new and repeated blood donors. Some differences of the nucleolar coefficient were also found in various seasons of the year before as well as after blood donation.
Acid-base and blood gas status of capillary blood from the ear was compared with acid-base and blood gas status of arterial and venous blood in dogs with induced hypoxemia, hypercapnea, and hypovolemia. It was concluded that capillary blood samples can replace arterial blood samples for the measurement of acid-base and blood gas status of dogs with severe impairment of lung function. When circulation is impaired capillary blood samples cannot replace arterial blood samples for the measurement of acid-base and blood gas status of dogs. With impaired capillary circulation, the capillary-arterial differences become unacceptably large. It is, therefore, advisable to submit samples of capillary blood for analysis only if circulation is not impaired and microtubes can be filled quickly and easily.
A 41-year-old male patient with well-controlled hypertension underwent a partial nephrectomy under total intravenous anesthesia with propofol, fentanyl and ketamine. To avoid allogeneic blood transfusion, preoperative autologous blood donation (400 g) a week before the surgery and acute normovolemic hemodilution (800 g) after induction of anesthesia were performed. As surgical blood loss was more than 4000 g, blood hemoglobin (Hb) level decreased to 6.4 g.dl-1. However, as intraoperative hemodynamics was relatively stable with no ischemic changes in ECG and arterial blood gas analysis did not show metabolic acidosis, autologous blood transfusion was withheld till hemostasis had been done. After returning the autologous blood, Hb increased to 9.4 g.dl-1. On the 2nd postoperative day, Hb decreased to 7.6 g.dl-1. As the patient's vital signs did not show any severe complications, blood transfusion was not performed. Then, the Hb level increased gradually to 13.9 g.dl-1, 3 month later without allogenic blood transfusion. In addition, any postoperative complications by low Hb level were not recognized so far. This case suggests that combination of autologous transfusion techniques may be effective to avoid allogeneic blood transfusion even against massive hemorrhage. However, to avoid disadvantage of these technique, we should always evaluate preoperative patient conditions.
A whole-blood aggregometer of red blood cells (RBC) is described. It consists of a transparent 0.26-cm ID vinyl tube of approximately 30 cm in length containing freshly drawn heparinized blood and a densitometer head that is attached to the tube. The densitometer head consists of an infrared light source of gallium arsenide and a light detector (silicon photodiode) to monitor changes in optical density of the blood in the tube. The tube and densitometer head were installed in a temperature-controlled box at 37 degrees C. The blood in the tube was first subjected to rapid flow with a solenoid so that the wall shear rate of the blood was approximately 500 s-1. The shear gave rise to a rapid increase in optical density of the blood due to dispersion of the blood corpuscles. The blood was then brought abruptly to a full stop. After the flow had stopped the densitometer head revealed a gradual decrease in optical density in association with RBC aggregate formation. The resultant pattern was termed by us an "RBC aggregogram." The RBC aggregogram exhibited an exponential decay in its initial part, which was followed by an asymptotic decrease. A simple mathematical procedure was employed to calculate the rate constant of the initial decrease from the two values on the RBC aggregogram at 10 and 20 s. The rate constant k10 was 0.192 +/- 0.028 (5.2 s as time constant; 3.6 s as half time) for feline blood and 0.129 +/- 0.012 (7.7 s as time constant; 5.3 s as half time) for human blood. The RBC aggregation rate varied linearly with the hematocrit below 40%.
Pseudocholinesterase (E.C. 3.1.1.8) activity was measured in plasma of whole blood, bank blood, and several commercially available blood protein solutions by means of a colorimetric assay technique at 25 degrees C, pH 7.7, and with butyrylthiocholine as substrate (Merckotest-R No. 3337). Activity of whole blood was 5.79 plus or minus 0.20 U x ml-1, of bank blood 4.53 plus or minus 0.27 U x ml-1, and of two human serum solutions (Biseko-R, Seretin-R) 3.05 plus or minus 0.13 and 3.04 plus or minus 0.22 U x ml-1, respectively (mean plus or minus S.E.M.). The other blood protein solutions contained no clinically significant esterase activity. Since transfusion of blood plasma has been suggested for treatment of cholinesterase deficiency and postoperative suxamethonium-induced muscle paralysis, an in-vitro attempt was carried out to correlate the amount of plasma necessary and the rise of pseudocholinesterase activity in the recipient's blood: A large amount of blood has to be transfused to yield a comparatively small increase in esterase activity. Thus, considering the potential hazards of blood transfusion, this treatment does not seem to be advisable.
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1. In studying forearm skeletal muscle substrate exchange, an often applied method for estimating skeletal muscle blood flow is strain gauge plethysmography. A disadvantage of this method is that it only measures total blood flow through a segment of forearm and not the flow through the individual parts such as skin, adipose tissue and muscle. 2. In the present study the contribution of forearm subcutaneous adipose tissue blood flow to total forearm blood flow was evaluated in lean (% body fat 17.0 +/- 2.2) and obese males (% body fat 30.9 +/- 1.6) during rest and during infusion of the non-selective beta-agonist isoprenaline. Measurements were obtained of body composition (hydrostatic weighing), forearm composition (magnetic resonance imaging) and of total forearm (venous occlusion plethysmography), skin (skin blood flow, laser Doppler), and subcutaneous adipose tissue blood flow (133Xe washout technique). 3. The absolute forearm area and the relative amount of fat (% of forearm area) were significantly higher in obese as compared to lean subjects, whereas the relative amounts of muscle and skin were similar. 4. During rest, the percentage contribution of adipose tissue blood flow to total forearm blood flow was significantly higher in lean compared with obese subjects (19 vs 12%, P < 0.05), whereas there were no differences in percentage contribution between both groups during isoprenaline infusion (10 vs 13%). Furthermore, the contribution of adipose tissue blood flow to total forearm blood flow was significantly lower during isoprenaline infusion than during rest in lean subjects (P < 0.05), whereas in the obese this value was similar during rest and during isoprenaline infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Few studies have examined the relation of blood pressure reactivity to subsequent change in blood pressure of preschool children. The authors investigated relations between measurement-induced reactivity, exercise reactivity, and change in blood pressure over 16 months among 140 preschool children (46-67 months of age at baseline, 50.7% female, 92.9% Hispanic). Within-session measurement-induced reactivity was defined as the change in blood pressure between the first and the mean of the fourth and fifth readings obtained at each of 11 sessions. Between-session measurement-induced reactivity was defined as the change between mean blood pressure at session 1 and the mean of sessions 2 and 3. Both indices of measurement reactivity displayed poor reproducibility. Exercise reactivity was measured using a treadmill on two occasions and was moderately reproducible. There was no association between measurement and exercise reactivity. The change in systolic blood pressure over time was not associated with any measure of reactivity. The mean diastolic blood pressure did not change over the study period. Neither blood pressure reactivity to measurement nor blood pressure reactivity to exercise appeared to be a useful predictor of change in blood pressure in preschool children during a 16-month period.
Seasonal, and animal size and weight variations of the blood cells of the vanadium-containing ascidian. Ascidia ceratodes, were determined. The fluorescent properties of various cell types were ascertained, and discussed in terms of cell development, phylogenic position of the species, and chemicals in the cells.
The connection between age, sex and some laboratory parameters (blood uric acid, glucose, cholesterol and triglycerides) has been studied on a very wide whole (22025 exams). An important datum which has appeared is that the increase of age is connected with an increase of the values of the parameters studied, and that the sex conditions differences which proved statistically significant.
In our miniature swine model of brain retraction ischemia under conditions simulating the neurosurgical operating room, we studied the effects of bolus mannitol (2 g/kg) administration on cerebral blood flow, blood pressure, blood viscosity, hematocrit, sodium, and potassium serially for 4 hours following administration, at which time a second bolus was administered. Both viscosity and hematocrit were significantly decreased transiently following both the first and second boluses. Sodium was decreased for 30 minutes following the first bolus, 15 minutes following the second bolus, and increased at 150 minutes and later following the second bolus. There was a mild decrease in blood pressure and a mild increase in cerebral blood flow following mannitol, but little difference between the first hour following a bolus (when the viscosity and hematocrit were decreased) and hours 2-4 (when they were near baseline). Mannitol's effects on blood pressure and cerebral blood flow probably depend on factors in addition to its effects on blood viscosity and hematocrit. The results are discussed in light of previous findings that bolus mannitol administration may improve cerebral blood flow in ischemia, but does not appear to benefit the preservation of brain electrical activity.
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We used the ConstaVac drainage retransfusion system in 32 patients operated on with cemented tricompartmental knee arthroplasty. The mean total postoperative bleeding was 1.1 L of which 0.7 L was retransfused within 8 hours postoperatively. Samples were taken from the venous blood and drain blood at 2 hours and 6-8 hours postoperatively. The drain blood had low counts for leukocytes and thrombocytes as compared to venous blood, and fibrinogen was almost absent. Incubation at room temperature slightly lowered glucose and pH which made the erythrocytes swell. There was a slight hemolysis in the drain blood at 2 hours. At 6-8 hours the shed blood was closer to normal, especially with regard to hemolysis, but there was a further decrease in glucose. Within this time, there was no change in acidity and no further swelling of the erythrocytes. No clinical adverse reactions were observed and we consider the observed cellular and chemical changes to be of little importance. The quality of filtered drain blood within the analyzed time limit is considered acceptable for clinical use.
The aim of this study was to investigate the flow fields of blood flowing through the curved bileaflet mechanical heart valve. A numerical analysis was carried out with the fluid-structure interaction between the blood flow and the motion of leaflets in two different types of blood vessels (type A, with sinus blood vessel, and type B, without sinus blood vessel). When the leaflet was fully opened, a fluttering phenomenon was detected in association with the blood flow, and recirculation flows were observed in the sinus region of the blood vessel for type A. During the closing phase, regurgitation was formed between the ring and the edge of the each leaflet for both types. When the leaflet came into contact with the valve ring at the end of the closing phase, rebound of the leaflet occurred. In consideration of the entire domain, the pressure drop occurs mainly in the valve region. The present results showed tendencies similar to those obtained by previous experiments for blood flow and contribute to the development of the curved bileaflet mechanical heart valve prostheses.
BACKGROUND: Increasing evidence suggests that ABPM more closely predicts target organ damage than does clinic measurement. Future guidelines may suggest ABPM as routine in the diagnosis and monitoring of hypertension. This would create difficulties as this test is expensive and often difficult to obtain. The purpose of this study is to determine the degree to which the BpTRU automatic blood pressure monitor predicts results on 24 hour ambulatory blood pressure monitoring (ABPM). METHODS: A quantitative analysis comparing blood pressure measured by the BpTRU device with the mean daytime blood pressure on 24 hour ABPM. The study was conducted by the Centre for Studies in Primary Care, Queen's University, Kingston, Ontario, Canada on adult primary care patients who are enrolled in two randomized controlled trials on hypertension. The main outcomes were the mean of the blood pressures measured at the three most recent office visits, the initial measurement on the BpTRU-100, the mean of the five measurements on the BpTRU monitor, and the daytime average on 24 hour ABPM. RESULTS: The group mean of the three charted clinic measured blood pressures (150.8 (SD10.26) / 82.9 (SD 8.44)) was not statistically different from the group mean of the initial reading on BpTRU (150.0 (SD21.33) / 83.3 (SD12.00)). The group mean of the average of five BpTRU readings (140.0 (SD17.71) / 79.8 (SD 10.46)) was not statistically different from the 24 hour daytime mean on ABPM (141.5 (SD 13.25) / 79.7 (SD 7.79)). Within patients, BpTRU average correlated significantly better with daytime ambulatory pressure than did clinic averages (BpTRU r = 0.571, clinic r = 0.145). Based on assessment of sensitivity and specificity at different cut-points, it is suggested that the initial treatment target using the BpTRU be set at <135/85 mmHG, but achievement of target should be confirmed using 24 hour ABPM. CONCLUSION: The BpTRU average better predicts ABPM than does the average of the blood pressures recorded on the patient chart from the three most recent visits. The BpTRU automatic clinic blood pressure monitor should be used as an adjunct to ABPM to effectively diagnose and monitor hypertension.