scholarly journals Improving Autologous Blood Harvest: Recovery of Red Cells from Sponges and Suction

1987 ◽  
Vol 15 (4) ◽  
pp. 421-424 ◽  
Author(s):  
A. K. Ronai ◽  
J. J. Glass ◽  
A. S. Shapiro
Keyword(s):  
Blood Loss ◽  
Autologous Blood ◽  
Cell Mass ◽  
Haemoglobin Concentration ◽  
Red Cells ◽  
Red Cell ◽  
Cell Salvage ◽  
Donor Blood ◽  
Red Cell Mass ◽  
Free Haemoglobin

The efficacy of red cell salvage was assessed under circumstances which simulated blood loss managed with sponges or suction. Expired banked blood was equally divided and processed by either suction, or absorbing the blood on a sponge followed by rinsing the sponge in saline. These two techniques were used to harvest washed, centrifuged erythrocytes. The volume, haematocrit and free haemoglobin concentration of the banked blood and the processed units were measured, and smears from all units were examined microscopically. The red cell mass was calculated as the product of the volume and haematocrit. The red cell mass recovered by suction and from sponges averaged 93% and 87% respectively. Blood lost in sponges can be recovered and used to increase the available autologous blood, thereby reducing the need for donor blood.

Intraoperative autologous blood donation preserves red cell mass but does not decrease postoperative bleeding

1996 ◽  
Vol 62 (5) ◽  
pp. 1431-1441 ◽  
Author(s):  
Robert E. Helm ◽  
John D. Klemperer ◽  
Todd K. Rosengart ◽  
Jeffrey P. Gold ◽  
Powers Peterson ◽  
...  
Keyword(s):  
Blood Donation ◽  
Autologous Blood ◽  
Postoperative Bleeding ◽  
Cell Mass ◽  
Red Cell ◽  
Autologous Blood Donation ◽  
Red Cell Mass

Blood disorders specific to pregnancy

2010 ◽  
pp. 2173-2180 ◽  
Author(s):  
David J. Perry ◽  
Katharine Lowndes
Keyword(s):  
Plasma Volume ◽  
Cell Mass ◽  
Haemoglobin Concentration ◽  
Red Cell ◽  
Blood Disorders ◽  
Red Cell Mass

Plasma volume increases by more during pregnancy than does red cell mass, leading to haemodilution and a fall in the haematocrit from about 40% to 33%, with the nadir usually reached at 24 to 32 weeks gestation. Anaemia during pregnancy is defined as a haemoglobin concentration of <10.5 g/dl during the second and third trimesters....

scholarly journals The Hematologic Response to Wounding and to Resuscitation Accomplished by Large Transfusions of Stored Blood

Blood ◽  
1954 ◽  
Vol 9 (5) ◽  
pp. 439-460 ◽  
Author(s):  
WILLIAM H. CROSBY ◽  
JOHN M. HOWARD
Keyword(s):  
Blood Group ◽  
Cell Mass ◽  
Cell Formation ◽  
Blood Stream ◽  
Red Cells ◽  
Red Cell ◽  
Tissue Destruction ◽  
Donor Blood ◽  
Universal Donor ◽  
Stored Blood

Abstract 1. During the third winter campaign in Korea, the hematologic reaction to wounding was studied in thirty-seven casualties at the time of initial resuscitation. 2. Of particular interest was the effect of massive transfusions of stored blood. The results of storage of blood—high plasma hemoglobin and potassium, low labile factor activity, nonviable platelets and leukocytes—had little deleterious effect on patients who received as much as 20 to 30 pints in less than six hours. The loss of transfused red cells because of nonviability was no more than expected. 3. At the time of resuscitation and shortly thereafter, there was a remarkable loss of circulating red cell mass in patients with wounds that involved much tissue destruction. It is believed that the loss was due to hemolysis but the mechanism is unknown. The loss of red cells may be so rapid that a patient with bilateral traumatic amputation of the legs and an adequate hemostasis would become severely anemic if one hesitated to use large, rapid transfusions. Patients with severe shock whose wounds involved less tissue damage (lacerated colon, for example) did not destroy red cells in this fashion. After moderate transfusions such patients often became polycythemic. Transfusions had to be carried out rather gingerly because of a tendency to develop signs of congestion. 4. During the early days of recuperation from severe wounds the patients often tended to become anemic. The anemia appeared to be the result of hemolytic processes plus a relative inhibition of red cell formation. 5. Universal donor blood, group O, was used in all transfusions. In patients who are not group O the massive transfusions resulted in the virtual replacement by red cells of another group. The patient’s plasma sometimes contained antibodies against red cells of his hereditary blood group. Gradual hemolysis of native red cells by transfused antibodies was observed. This was not a clinical hemolytic reaction and did not appear to be detrimental to the patient. The presence of the foreign antibodies made it impossible in some cases to crossmatch the patient with blood of his hereditary group and suggested a source of danger in attempting such transfusions. After transfusion with the universal donor blood has begun, it is recommended that no change be made to blood of another group until at least two weeks have elapsed. 6. No incompatible transfusion reactions were encountered. Several hemoclastic reactions may have been caused by gross contamination of the blood stream from the site of wounds or from the peritoneal cavity.

scholarly journals Further Observations on Polycythemia in Hepatocellular Carcinoma

Blood ◽  
1961 ◽  
Vol 18 (5) ◽  
pp. 592-598 ◽  
Author(s):  
Y. W. KAN ◽  
A. J. S. MCFADZEAN ◽  
D. TODD ◽  
S. C. TSO
Keyword(s):  
Hepatocellular Carcinoma ◽  
Direct Measurement ◽  
Cell Mass ◽  
Red Cells ◽  
Cirrhosis Of The Liver ◽  
Red Cell ◽  
Red Cell Mass ◽  
Stimulating Factor ◽  
Fasted Rats

Abstract Direct measurement of the red cell mass has confirmed a previous report of the occurrence of polycythemia in patients with hepatocellular carcinoma. Twenty patients (17 males and 3 females) have been investigated. The red cell mass was increased in 11, normal in 8 and reduced in one. Because of hypervolemia, present in 15 of the 20 patients investigated and attributable to the associated cirrhosis of the liver, the hematocrit might be normal in the presence of an increased red cell mass. A venous hematocrit of 48 per cent and above was found invariably to be associated with an increase in the red cell mass. Using this criterion, 17 of 145 patients with hepatocellular carcinoma were found to be polycythemic, an incidence of 11.7 per cent. Plasma erythropoietic stimulating factor determined by Fe59 incorporation into red cells of fasted rats was not increased in 4 patients with hepatocarcinoma and polycythemia. These findings are briefly discussed.

scholarly journals The Metabolism of Transferrin-bound 111In and 59Fe in the Rat

Blood ◽  
1974 ◽  
Vol 43 (5) ◽  
pp. 693-701 ◽  
Author(s):  
Michael R. Beamish ◽  
Elmer B. Brown
Keyword(s):  
Cell Mass ◽  
Red Cells ◽  
In Vivo Studies ◽  
Red Cell ◽  
Red Marrow ◽  
Significant Difference ◽  
Red Cell Mass ◽  
Residual Radioactivity ◽  
Uptake And Release

Abstract The metabolism of transferrin-bound indium and iron were compared by in vivo studies in the rat. Rats were injected with serum transferrin labeled with 111In and 59Fe, and, at intervals ranging from 20 min to 5 days after injection, they were killed. They were perfused through the portal vein with 200 ml of 0.9% saline, and the residual radioactivity, expressed as a percentage of the injected dose, was measured in liver, spleen, kidney, muscle, washed red cells, red marrow, and femur. At 5 days, 76% of the injected 59Fe was recovered in the red cell mass; only 1%-2% of 111In could then be recovered. Uptake and release of the 111In label by the femur was markedly less than that of the 59Fe. Whereas 85% of the injected 59Fe could be recovered from the circulating red cells, liver, and spleen, only about 15% of the injected 111In could be so recovered. Approximately 35% of the injected 111In was excreted, and 43% was recoverable from the carcass. The subcellular distribution of the two isotopes in the liver at timed intervals following intravenous injection was studied. While 35% of the 59Fe activity in the homogenate was associated with ferritin, only 4% of the 111In could be so identified. The results indicate a significant difference between the metabolism of 111In and 59Fe in the rat and make it unlikely that the metabolism of In in man bears much similarity to that of iron.

Letters to the Editor

PEDIATRICS ◽  
1967 ◽  
Vol 40 (5) ◽  
pp. 926-926
Author(s):  
ARTHUR J. MOSS ◽  
MICHELLE MONSET-COUCHARD
Keyword(s):  
Cell Mass ◽  
Time Factor ◽  
Red Cells ◽  
Red Cell ◽  
Letters To The Editor ◽  
Uterine Contractions ◽  
Red Cell Mass ◽  
The Many ◽  
Definition Of

Many of the issues raised by Dr. Baum are discussed in the original article, i.e., the importance of the influence of gravity and of uterine contractions as well as the onset of respirations and the time factor. Because of the many unknown and complex factors, a definition of placental transfusion was not attempted. Concerning Dr. Baum's proposed definition, it would seem to be purely theoretic to consider a "redistribution" of red cells between the placental and fetal circulations since, to our knowledge, neither the total circulating red cell mass of the placenta and baby nor its prenatal distribution is known.

scholarly journals Reduction in massive postpartum haemorrhage and red blood cell transfusion during a national quality improvement project, Obstetric Bleeding Strategy for Wales, OBS Cymru: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah F. Bell ◽  
Rachel E. Collis ◽  
Philip Pallmann ◽  
Christopher Bailey ◽  
Kathryn James ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Red Cells ◽  
National Database ◽  
Care Bundle ◽  
Red Cell ◽  
National Quality ◽  
Red Cell Transfusion

Abstract Background Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality and its incidence is increasing in many countries despite management guidelines. A national quality improvement programme called the Obstetric Bleeding Strategy for Wales (OBS Cymru) was introduced in all obstetric units in Wales. The aim was to reduce moderate PPH (1000 mL) progressing to massive PPH (> 2500 mL) and the need for red cell transfusion. Methods A PPH care bundle was introduced into all 12 obstetric units in Wales included all women giving birth in 2017 and 2018 (n = 61,094). The care bundle prompted: universal risk assessment, quantitative measurement of blood loss after all deliveries (as opposed to visual estimation), structured escalation to senior clinicians and point-of-care viscoelastometric-guided early fibrinogen replacement. Data were submitted by each obstetric unit to a national database. Outcome measures were incidence of massive PPH (> 2500 mL) and red cell transfusion. Analysis was performed using linear regression of the all Wales monthly data. Results Uptake of the intervention was good: quantitative blood loss measurement and risk assessment increased to 98.1 and 64.5% of all PPH > 1000 mL, whilst ROTEM use for PPH > 1500 mL increased to 68.2%. Massive PPH decreased by 1.10 (95% CI 0.28 to 1.92) per 1000 maternities per year (P = 0.011). Fewer women progressed from moderate to massive PPH in the last 6 months, 74/1490 (5.0%), than in the first 6 months, 97/1386 (7.0%), (P = 0.021). Units of red cells transfused decreased by 7.4 (95% CI 1.6 to 13.2) per 1000 maternities per year (P = 0.015). Red cells were transfused to 350/15204 (2.3%) and 268/15150 (1.8%) (P = 0.001) in the first and last 6 months, respectively. There was no increase in the number of women with lowest haemoglobin below 80 g/L during this time period. Infusions of fresh frozen plasma fell and there was no increase in the number of women with haemostatic impairment. Conclusions The OBS Cymru care bundle was feasible to implement and associated with progressive, clinically significant improvements in outcomes for PPH across Wales. It is applicable across obstetric units of widely varying size, complexity and staff mixes.

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