Microcirculation follows macrocirculation in heart and gut in the acute phase of hemorrhagic shock and isovolemic autologous whole blood resuscitation in pigs

Transfusion ◽  
2011 ◽  
Vol 52 (7) ◽  
pp. 1552-1559 ◽  
Author(s):  
Mat van Iterson ◽  
Rick Bezemer ◽  
Michal Heger ◽  
Martin Siegemund ◽  
Can Ince
Keyword(s):  
Hemorrhagic Shock ◽  
Acute Phase ◽  
Whole Blood ◽  
Autologous Whole Blood

Systemic and microcirculatory effects of autologous whole blood resuscitation in severe hemorrhagic shock

1999 ◽  
Vol 276 (6) ◽  
pp. H2035-H2043 ◽  
Author(s):  
Heinz Kerger ◽  
Klaus F. Waschke ◽  
Klaus V. Ackern ◽  
Amy G. Tsai ◽  
Marcos Intaglietta
Keyword(s):  
Metabolic Acidosis ◽  
Hemorrhagic Shock ◽  
Whole Blood ◽  
Tissue Perfusion ◽  
Capillary Density ◽  
Shed Blood ◽  
Syrian Golden Hamsters ◽  
Autologous Whole Blood ◽  
Significant Impairment ◽  
Main Determinants

Systemic and microcirculatory effects of autologous whole blood resuscitation after 4-h hemorrhagic shock with a mean arterial pressure (MAP) level of 40 mmHg were investigated in 63 conscious Syrian golden hamsters. Microcirculation of skeletal skin muscle and subcutaneous connective tissue was visualized in a dorsal skinfold. Shed blood was retransfused within 30 min after 4 h. Animals were grouped into survivors in good (SG) and poor condition (SP) and nonsurvivors (NS) according to 24-h outcome after resuscitation and studied before shock, during shock (60, 120, and 240 min), and 30 min and 24 h after resuscitation. Microvascular and interstitial[Formula: see text] values were determined by phosphorescence decay. Shock caused a significant increase of arterial[Formula: see text] and decrease of[Formula: see text], pH, and base excess. In the microcirculation, there was a significant decrease in blood flow (Q˙B), functional capillary density (FCD; capillaries with red blood cell flow), and interstitial [Formula: see text][1.8 ± 0.8 mmHg (SG), 1.3 ± 1.3 mmHg (SP), and 0.9 ± 1.1 mmHg (NS) vs. 23.0 ± 6.1 mmHg at control]. Blood resuscitation caused immediate MAP recompensation in all animals, whereas metabolic acidosis, hyperventilation, and a significant interstitial [Formula: see text] decrease (40–60% of control) persisted. In NS (44.4% of the animals), systemic and microcirculatory alterations were significantly more severe both in shock and after resuscitation than in survivors. Whereas in SG (31.8% of the animals) there was only a slight (15–30%) but still significant impairment of microscopic tissue perfusion (Q˙B, FCD) and oxygenation at 24 h, SP (23.8% of the animals) showed severe metabolic acidosis and substantial decreases (≥50%) of FCD and interstitial[Formula: see text]. FCD, interstitial[Formula: see text], and metabolic state were the main determinants of shock outcome.

Fluid resuscitation with O2 vs. non-O2 carriers after 2 h of hemorrhagic shock in conscious hamsters

1997 ◽  
Vol 272 (1) ◽  
pp. H525-H537 ◽  
Author(s):  
H. Kerger ◽  
A. G. Tsai ◽  
D. J. Saltzman ◽  
R. M. Winslow ◽  
M. Intaglietta
Keyword(s):  
Blood Pressure ◽  
Hemorrhagic Shock ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Whole Blood ◽  
Shed Blood ◽  
Arterial Blood ◽  
Dextran 70 ◽  
Autologous Whole Blood ◽  
Tissue Po2

Efficacy of a cell-free o-raffinose cross-linked and oligomerized hemoglobin (Hemo-link) solution in restoring macro- and microcirculatory conditions after 2 h of hemorrhagic shock (40 mmHg) was compared with conventional treatment with autologous whole blood, Ringer lactate (RL), and Dextran 70. Studies were conducted in the dorsal skinfold microcirculation of conscious hamsters. Initial infusion was equivalent to shed blood volume (SBV) for RL and 50% of SBV for remaining solutions. After 2 h all animals received blood at 50% of SBV. Vessel diameter, functional capillary density, microvascular red blood cell velocity, and flow were measured. Arteriolar, venular, and tissue PO2 were determined by phosphorescence decay. Systemic parameters included mean arterial blood pressure, heart rate, arterial blood gases, pH, and base excess. Autologous whole blood and Hemolink, but not Dextran 70 and RL, restored mean arterial blood pressure, systemic blood gas, and metabolic parameters. Tissue PO2 recovered to 40–50% with blood and Hemolink but remained significantly lower (10-15% of control) with Dextran 70 and RL. Initial volume replacement after shock with blood or Hemolink yields equivalent macro- and microhemodynamic improvements not attainable with non-O2-carrying plasma expanders.

scholarly journals Preemptive intravenous iron therapy versus autologous whole blood therapy for early postoperative hemoglobin level in patients undergoing bimaxillary orthognathic surgery: a prospective randomized noninferiority trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Whole Blood ◽  
Orthognathic Surgery ◽  
Hemoglobin Level ◽  
Iron Therapy ◽  
Iron Group ◽  
Autologous Whole Blood ◽  
Bimaxillary Orthognathic Surgery ◽  
Iv Iron

Abstract Background Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery. Methods This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was − 1 g/dL. Results Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group—whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = − 0.83 to 1.0). As the lower limit of the 95% CI (− 0.83) was higher than the prespecified noninferiority margin (δ = − 1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery. Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019. https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my.

Supplemental fish oil does not alter immune competence or the pathophysiological response to an intramammary infusion of endotoxin in peri-partum multiparous Holstein cows

2009 ◽  
Vol 76 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Michael A Ballou ◽  
Rodrigo C Gomes ◽  
Edward J DePeters
Keyword(s):  
Antimicrobial Activity ◽  
Fish Oil ◽  
Acute Phase ◽  
Whole Blood ◽  
Acute Phase Response ◽  
Post Partum ◽  
Interferon Γ ◽  
Phase Response ◽  
Holstein Cows ◽  
Immune Competence

The objective was to determine the effects of supplementing the diet with fish oil during the peri-partum period on the immune competence and the pathophysiological response to a lipopolysaccharide-induced mastitis challenge. Multiparous Holstein cows (n=30) were completely randomized to one of two treatments at 3 weeks pre-partum. Treatments differed only in the source of supplemental lipid and included either Energy Booster® or fish oil. Treatment diets were fed from −21 d relative to expected date of parturition until 10 d post partum. Treatments were fed as a bolus prior to the a.m. feeding. The dose of lipid during the pre-partum period was 250 g/d, whereas the amount of lipid supplemented post partum was adjusted to the level of intake, approximately 0·92% of the previous day's dry matter intake. Ex-vivo analyses of immune competence were measured including the antimicrobial activity of whole blood against Escherichia coli, Salmonella typhimurium and Candida albicans as well as the production of interferon-γ by peripheral blood mononuclear cultures. At 7 days in milk cows were infused with 100 μg of Esch. coli lipopolysaccharide into one rear quarter. Supplementing fish oil increased plasma concentrations of eicosapentaenoic and docosahexaenoic acids, but had no affect on the proportions of arachidonic acid at calving. Fish oil did not influence the production of interferon-γ or the antimicrobial activity of whole blood against any of the microorganisms. Furthermore, fish oil had no ameliorative effect on either the local or the systemic acute phase response following an intramammary lipopolysaccharide challenge in early lactating Holstein cows. Supplementing fish oil in the diet of peri-partum cows will not protect them from deleterious effects of an excessive acute phase response.

scholarly journals Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Leyla Sedighipour ◽  
Seyed Mansoor Rayegani ◽  
Mohammad Hasan Bahrami ◽  
Masume Bayat ◽  
...  
Keyword(s):  
Whole Blood ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Pressure Pain Threshold ◽  
Lateral Epicondylitis ◽  
Autologous Whole Blood ◽  
Significant Difference ◽  
Group 2 ◽  
And Function

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

scholarly journals Preemptive intravenous iron therapy versus autologous whole blood therapy for early postoperative hemoglobin level in patients undergoing bimaxillary orthognathic surgery: A prospective randomized noninferiority trial

2020 ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Whole Blood ◽  
Orthognathic Surgery ◽  
Hemoglobin Level ◽  
Iron Therapy ◽  
Iron Group ◽  
Autologous Whole Blood ◽  
Bimaxillary Orthognathic Surgery ◽  
Iv Iron

Abstract Background: Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery.Methods: This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was –1 g/dL. Results: Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group – whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = –0.83 to 1.0). As the lower limit of the 95% CI (–0.83) was higher than the prespecified noninferiority margin (δ = –1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion: As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery.Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my

Use of levarterenol in treatment of irreversible hemorrhagic shock

1959 ◽  
Vol 196 (5) ◽  
pp. 1029-1032 ◽  
Author(s):  
H. A. Fozzard ◽  
J. P. Gilmore
Keyword(s):  
Hemorrhagic Shock ◽  
Survival Time ◽  
Whole Blood ◽  
Hemorrhagic Hypotension ◽  
Effective Adjunct

The effectiveness of levarterenol in the treatment of shock resulting from prolonged oligemia was studied in the dog. The survival time of animals receiving levarterenol and whole blood therapy was significantly greater than that of animals receiving a placebo and whole blood. The results of the experiments indicate that levarterenol is an effective adjunct to whole blood therapy in the treatment of shock resulting from prolonged hemorrhagic hypotension.

Whole Blood Chemiluminescence As an Acute Phase Reactant

1986 ◽  
Vol 28 (2) ◽  
pp. 189-194
Author(s):  
Tatsuhito Tono-oka ◽  
Takahide Matsumoto ◽  
Yuichi Taguchi ◽  
Masanori Nakanishi ◽  
Ko Imai
Keyword(s):  
Acute Phase ◽  
Whole Blood ◽  
Acute Phase Reactant ◽  
Phase Reactant
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