scholarly journals THE TREATMENT OF ERYTHROBLASTOSIS FETALIS BY TRANSFUSION WITH SEDIMENTED RED CELLS

Blood ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 107-122 ◽  
Author(s):  
SAMUEL PENNELL
Keyword(s):  
Mortality Rate ◽  
Exchange Transfusion ◽  
Sodium Citrate ◽  
Red Cells ◽  
Not Given ◽  
Therapeutic Procedure ◽  
Case Histories ◽  
Bank Blood ◽  
Agglutinin Titer

Abstract 1. A method is described for the treatment of patients with erythroblastosis fetalis by the transfusion of compatible sedimented red cells from bank blood. 2. The case histories of 28 patients with erythroblastosis fetalis, treated by this method, have been analyzed. Three, or 10.7 per cent, of the patients died. This mortality rate compares favorably with other reports in which exchange transfusion was the therapeutic procedure. 3. The transfusion of sedimented red cells in 50-60 cc. amounts is sufficient to cause an adequate rise in the hemoglobin values with a minimum of load on the infant’s circulation. 4. This method, in contrast to that of exchange transfusion, has the advantage of reducing the administration of plasma to a minimum, thereby preventing further hemolysis of the infant’s red cells by enhancing the agglutinin titer. In addition, excessive amounts of extraneous substances such as sodium citrate are not given.

MODIFICATION OF THE TECHNIC OF TREATING ERYTHROBLASTOSIS FETALIS BY EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1951 ◽  
Vol 8 (1) ◽  
pp. 117-127
Author(s):  
ALEXANDER S. WIENER ◽  
IRVING B. WEXLER
Keyword(s):  
Statistical Analysis ◽  
Mortality Rate ◽  
Red Blood Cells ◽  
Clinical Features ◽  
Blood Cells ◽  
Exchange Transfusion ◽  
Red Cells ◽  
Simplified Method ◽  
Adult Plasma

A simplified method of treating erythroblastosis by exchange transfusion is described in which the patient is bled and simultaneously transfused with compatible packed red cells. A table is presented which gives the final hematocrit and percentage of inagglutinable red blood cells in the patient's body at the termination of the exchange transfusion, in relation to the patient's initial hematocrit and the amount of blood exchanged. An exchange transfusion with 100 to 150 cc. of packed cells appears to be adequate regardless of the severity of the anemia. Statistical analysis of the result of 106 exchange transfusions shows a progressive drop in mortality rate from 23.7% in 38 cases treated with 500 cc. of whole citrated blood, to 14.6 cc. in 48 cases treated with 1,000 cc. of whole citrated blood, and to 10.0% in 20 cases treated with 120 cc. of packed cells. While the improvement may be accidental, there is no doubt that exchange transfusion with packed cells is a simpler procedure which avoids the introduction into the patient's body of large amounts of adult plasma, and potentially toxic doses of citrate and calcium. Two cases are described in detail which have unusual serologic and clinical features and illustrate the types of problems which may arise when treating erythroblastotic babies.

Hemolytic Disease of the Newborn in South African Europeans and Bantu 1946-1960

PEDIATRICS ◽  
1964 ◽  
Vol 33 (4) ◽  
pp. 632-632
Author(s):  
JEROLD F. LUCEY
Keyword(s):  
Mortality Rate ◽  
South African ◽  
Exchange Transfusion ◽  
Diagnosis And Treatment ◽  
Not Given ◽  
Hemolytic Disease

This thesis is a summary of the author's experience in the diagnosis and treatment of hemolytic disease of the newborn in the pre-exchange transfusion era 1946-1949 (35 infants) and in the exchange transfusion era 1951-1960 (322 infants). The author's over-all mortality rate of 8.5% among all erythroblastotic infants receiving exchange transfusions compares favorably with that reported by other authors. Only twelve infants in this series required repeat exchange transfusions! The criteria used to select infants for repeat transfusions are not given.

In Vitro Assay of Platelet Adhesiveness with Washed and Tanned Human Red Cells

1968 ◽  
Vol 20 (03/04) ◽  
pp. 384-396 ◽  
Author(s):  
G Zbinden ◽  
S Tomlin
Keyword(s):  
Platelet Adhesion ◽  
Sodium Citrate ◽  
Blood Platelets ◽  
In Vitro Assay ◽  
Red Cells ◽  
Platelet Adhesiveness ◽  
Vitro Assay ◽  
In Vitro System ◽  
Human Red Cells

SummaryAn in vitro system is described in which adhesion of blood platelets to washed and tannic acid-treated red cells was assayed quantitatively by microscopic observation. ADP, epinephrine and TAME produced a reversible increase in platelet adhesiveness which was antagonized by AMP. With Evans blue, polyanetholsulfonate, phthalanilide NSC 38280, thrombin and heparin at concentrations above 1-4 u/ml the increase was irreversible. The ADP-induced increase in adhesiveness was inhibited by sodium citrate, EDTA, AMP, ATP and N-ethylmaleimide. EDTA, AMP and the SH-blocker N-ethylmaleimide also reduced spontaneous platelet adhesion to red cells. No significant effects were observed with adenosine, phenprocoumon, 5-HT, phthalanilide NSC 57155, various estrogens, progestogens and fatty acids, acetylsalicylic acid and similarly acting agents, hydroxylamine, glucose and KCN. The method may be useful for the screening of thrombogenic and antithrombotic properties of drugs.

Exchange transfusion: Evaluating the use of a mixture of citrated red cells and heparinized plasma

1992 ◽  
Vol 151 (11) ◽  
pp. 851-854
Author(s):  
W. J. C. Valk ◽  
K. D. Liem ◽  
B. A. van Dijk
Keyword(s):  
Exchange Transfusion ◽  
Red Cells

Intraoperative recovery of blood during TURP

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 87-89
Author(s):  
G. Pitrolo ◽  
A. Alborghetti ◽  
V. Bano
Keyword(s):  
Successful Treatment ◽  
Transurethral Resection ◽  
Benign Prostatic Hypertrophy ◽  
Prostatic Hypertrophy ◽  
Red Cells ◽  
Second Phase ◽  
Case Histories ◽  
Surgical Case ◽  
Preliminary Study

In consideration of surgical case histories in their hospital and the transfusion risks to which patients operated for Benign Prostatic Hypertrophy are exposed, the authors decided to verify the possibility of applying intraoperative recovery of blood in patients undergoing transurethral resection of the prostate (TURP). The preliminary study of 31 cases provided data which were encouraging with regard to the possibility of using this method and the reinfusion of the red cells recovered. The second phase involved the successful treatment of 53 patients who thus received the blood they had lost during surgery.

MORTALITY OF EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1960 ◽  
Vol 26 (5) ◽  
pp. 745-755
Author(s):  
Thomas R. Boggs ◽  
Milton C. Westphal
Keyword(s):  
Mortality Rate ◽  
Critical Analysis ◽  
Exchange Transfusion ◽  
Umbilical Vein ◽  
Clinical Status ◽  
Great Majority ◽  
Hemolytic Disease ◽  
Donor Blood ◽  
Initial Procedure ◽  
Definition Of

We have presented the experience of an exchange transfusion service in performing 1,139 procedures over a 7-year period. The design and practices of this service have been described in order to provide the background necessary for a critical analysis of our results. Since no definition exists for "Mortality of Exchange Transfusion," we have suggested one. The outstanding features of this experience were: 1. The umbilical vein approach proved to be an extremely easy technique by which to initiate an exchange transfusion. 2. The great majority of the procedures were completed as planned. 3. In all but a very few exchange transfusions, a volume of donor blood at least 1.5 times the infant's blood volume was infused. We could show no correlations between the volume of donor blood employed in an initial procedure and the need for a repeat exchange. 4. Most of our exchange transfusions were completed in less than 1 hour; many in less than 30 minutes. We were unable to demonstrate a higher morbidity or mortality in infants being subjected to a faster as opposed to a slower procedure. 5. The best definition of the mortality rate of exchange transfusion appears to be the number of infants dying during or within 6 hours of a procedure expressed as a percentage of the number of infants transfused and again as a percentage of the number of exchange transfusions performed. 6. The incidence of death during or within 6 hours of an exchange transfusion appeared to be more closely related to an infant's clinical status at the beginning of a procedure then to the procedure itself. Most of the deaths occurred among critically ill infants with Rh-hemolytic disease. Vigorous infants, full-term or premature, regardless of diagnosis, tolerated exchange transfusions well. Our mortality rate in vigorous infants was very low.

scholarly journals THE PRESERVATION OF LIVING RED BLOOD CELLS IN VITRO

1916 ◽  
Vol 23 (2) ◽  
pp. 239-248 ◽  
Author(s):  
Peyton Rous ◽  
J. R. Turner
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Large Scale ◽  
Blood Count ◽  
Sodium Citrate ◽  
Human Cells ◽  
Red Cells ◽  
Long Time ◽  
And Function

In order to determine the availability for functional uses of red cells kept in vitro by our methods, transfusion experiments have been carried out with rabbits by which a large part of their blood was replaced with kept rabbit cells suspended in Locke's solution. It has been found that erythrocytes preserved in mixtures of blood, sodium citrate, saccharose, and water for 14 days, and used to replace normal blood, will remain in circulation and function so well that the animal shows no disturbance, and the blood count, hemoglobin, and percentage of reticulated red cells remain unvaried. Cells kept for longer periods, though intact and apparently unchanged when transfused, soon leave the circulation. Animals in which this disappearance of cells is taking place on a large scale, remain healthy save for the progressing anemia. The experiments prove that, in the exsanguinated rabbit at least, transfusions of cells kept for a long time in vitro may be used to replace the blood lost, and that when the cells have been kept too long but are still intact they are disposed of without harm. The indications are that kept human cells could be profitably employed in the same way.

scholarly journals RESULTS OF THERAPY OF ERYTHROBLASTOSIS WITH EXCHANGE TRANSFUSION

Blood ◽  
1949 ◽  
Vol 4 (1) ◽  
pp. 1-35 ◽  
Author(s):  
ALEXANDER S. WIENER ◽  
IRVING B. WEXLER
Keyword(s):  
Saphenous Vein ◽  
Exchange Transfusion ◽  
Operative Mortality ◽  
Reliable Index ◽  
Fresh Blood ◽  
Transfusion Therapy ◽  
Moderate Severity ◽  
Supplementary Treatment ◽  
Severity Of The Disease ◽  
Bank Blood

Abstract 1. In the authors’ technic of exchange transfusion, citrated blood is introduced into the saphenous vein at the ankle and the infant’s blood simultaneously withdrawn from the radial artery at the wrist, coagulation being prevented by the administration of small amounts of heparin. The procedure besides being simple, is safe, there having been no operative mortality in more than 40 transfusions. 2. The results of exchange transfusion therapy in erythroblastosis in our first 28 cases are presented. Of these 28 cases, 16 were very severe and almost certainly would have been lethal if left untreated, 6 were of moderate severity, and 6 were mild. Only 7 of the infants died, and the available data indicate that the mortality would have been at least twice as high had the usual treatment with simple transfusions been given. 3. Aside from its greater efficacy in reducing mortality, exchange transfusion is more efficient, so that supplementary treatment is not required as a rule. 4. Fresh blood should be used instead of bank blood because of its greater survival time and smaller likelihood of introducing infection. 5. All infants who have survived have developed normally both physically and mentally and have shown no sequelae of liver or brain damage. 6. The most reliable index of the severity of the disease in the erythroblastotic infant is provided by antenatal titrations of the maternal univalent Rh antibodies, as well as by tests for the presence of univalent antibodies in the infant’s blood.

BORIC ACID POISONING TREATED BY EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1955 ◽  
Vol 16 (1) ◽  
pp. 109-114
Author(s):  
Thomas R. Boggs ◽  
Harry G. Anrode
Keyword(s):  
Mortality Rate ◽  
Boric Acid ◽  
Blood Volume ◽  
High Mortality ◽  
Acid Content ◽  
Exchange Transfusion ◽  
Specific Therapy ◽  
Circulating Blood Volume ◽  
New Approach

A new approach to the treatment of boric acid poisoning is presented. In the absence of any antidote or specific therapy for this type of poisoning, an exchange transfusion using a quantity of blood approximately 4 times the patient's blood volume was performed. The amount of boric acid removed was quantitatively measured by a technique which is described. The values thus obtained demonstrated that the exchange transfusion resulted in the removal of at least 36 per cent of the total boric acid in this infant's body. Twenty-four hours later a second exchange transfusion was performed using a volume of blood 2 times the infant's circulating blood volume. This exchange was shown to have resulted in the removal of 20 per cent of the remaining boric acid. In view of the high mortality rate previously reported in similar cases, we believe that the performance of this procedure on our patient materially contributed to his recovery. The favorable evidence presented in this report, suggests that exchange transfusion should be undertaken in selected cases of boric acid poisoning and is worthy of further evaluation. Semi-quantitative and quantitative techniques for the estimation of the boric acid content of blood and urine are described.

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