Use of a hemoglobin substitute in the anemic Jehovah's Witness patient

1994 ◽  
Vol 14 (1) ◽  
pp. 31-38 ◽  
Author(s):  
TR Marelli
Keyword(s):  
Blood Transfusion ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Severe Anemia ◽  
Transfusion Therapy ◽  
Acute Anemia ◽  
First Choice ◽  
Religious Convictions ◽  
Effective Drugs ◽  
Witness Patient

Fluosol DA is an experimental means of supplementing oxygen delivery in the anemic patient. The drug's ability to improve oxygen transport appears to improve SVO2. Blood transfusion is the first choice for acute anemia secondary to hemorrhage; however, perfluorochemicals offer an alternative for the patient who cannot accept transfusion therapy. This article reports a case of severe anemia in which transfusion was refused because of the patient's religious convictions. Perfluorochemicals represented an effective medical treatment that was compatible with this patient's religious beliefs. Continued research in artificial oxygen transporters may lead to even more effective drugs for the treatment of acute anemia, possibly decreasing the need for blood transfusion for all patients.

scholarly journals Development of an Automated Device for the Procedure of Blood Transfusion in Newborns

2020 ◽  
Vol 3 (3) ◽  
pp. 279-287
Author(s):  
Patrícia Quariguazy da Frota ◽  
Josiane Dantas Viana Barbosa ◽  
Paulo Roberto Freitas Neves
Keyword(s):  
Blood Transfusion ◽  
Literature Review ◽  
Medical Device ◽  
Neonatal Jaundice ◽  
Maternal Antibodies ◽  
Volume Replacement ◽  
Hemolytic Disease ◽  
Transfusion Therapy ◽  
Erythrocyte Hemolysis ◽  
First Choice

Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, is a problem of fetal erythrocyte hemolysis. This may happen due to the sensitization of maternal antibodies through the placental route. It is the pathology most frequently found in neonatal patients. Approximately 98% of maternal alloimmunization cases by erythrocyte antigens are due to the RhD factor. Phototherapy is the first choice in the treatment of neonatal jaundice. Blood transfusion is the therapy instituted for the treatment of severe neonatal disease. This study aimed to develop an automated device for performing the blood transfusion procedure. The method was developed in four stages: (1) Literature review about the search for theoretical references based on scientific articles and textbooks on transfusion therapy in the newborn; (2) Elaboration of the device consisted of items related to its assembly and structuring; (3) Operation of the medical device, including specific schedules related to the execution of the procedure; (4) Performing tests with simulating the purpose of volume replacement in the total cycle performed in the exsanguine transfusion procedure. The results showed that it was possible to assemble, reproduce, and implement the automation of the device developed for the exsanguine transfusion procedure in a practical. Also, the procedure presented security and effectiveness in the clinical treatment related to HDN.  

scholarly journals The role of metabolic adaptation of the functional state of circulating erythron in determining the course of traumatic disease in patients with massive blood loss in polytrauma

2020 ◽  
Vol 24 (4) ◽  
pp. 689-693
Author(s):  
Yu. A. Tygai ◽  
K. G. Mikhnevich
Keyword(s):  
Blood Loss ◽  
Functional State ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Intensive Therapy ◽  
Metabolic Adaptation ◽  
Transfusion Therapy ◽  
Group I ◽  
Oxygen Delivery Index ◽  
Group Ii

Annotation. Metabolic adaptation of the functional state of circulating erythron is an important criterion for predicting the course of traumatic disease in patients with polytrauma, which is accompanied by heavy blood loss. The aim of the study was to increase the effectiveness of treatment of patients with polytrauma with hemorrhagic shock by developing and implementing a differentiated approach to infusion and transfusion therapy, based on elucidation of the mechanisms of systemic oxygen transport in the postoperative period. The index of erythrocyte transformation index, oxygen delivery index as a leading indicator of oxygen transport system in patients of group I who received intensive therapy according to the classical algorithm, in patients of group II who were additionally prescribed ceruloplasmin solution, in patients of group III who were additionally prescribed a solution of D-fructose-1,6-diphosphate sodium salt hydrate. To determine the functional state of erythrocytes and their ability to deform, we used the method of scanning electron microscopy. Statistical data processing was performed using Student’s t-test (for n<100) at a given level of reliability p=0.95. The statistical analysis of the obtained data revealed a probable reduction in the number of doses of heterogeneous erythrocytes received by patients with high blood loss in polytrauma in patients of group II on the background of maximum ability of erythrocytes to transform while maintaining the oxygen delivery index at a satisfactory level. In the future it is planned to study the morphofunctional parameters of erythrocytes in this group of patients.

scholarly journals Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery

2011 ◽  
Vol 114 (2) ◽  
pp. 283-292 ◽  
Author(s):  
Laurent G. Glance ◽  
Andrew W. Dick ◽  
Dana B. Mukamel ◽  
Fergal J. Fleming ◽  
Raymond A. Zollo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Noncardiac Surgery ◽  
Pulmonary Complications ◽  
Wound Complications ◽  
Severe Anemia ◽  
Thromboembolic Complications ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

Background The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively. Methods This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. Results Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37). Conclusions Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.

A case study of an older adult with severe anemia refusing blood transfusion

2007 ◽  
Vol 19 (1) ◽  
pp. 43-48 ◽  
Author(s):  
C. Michelle Thomas ◽  
Harriet R. Coleman ◽  
Leslie-Faith Morritt Taub
Keyword(s):  
Blood Transfusion ◽  
Older Adult ◽  
Severe Anemia

Abstract TP402: Sickle Cell Disease in Pediatric Stroke - Inpatient Resource Utilization in the Decade Following STOP

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
J. Michael Taylor ◽  
Paul Horn ◽  
Heidi Sucharew ◽  
Todd A Abruzzo ◽  
Jane Khoury
Keyword(s):  
Sickle Cell Disease ◽  
Blood Transfusion ◽  
Sickle Cell ◽  
Care Utilization ◽  
Cell Disease ◽  
Common Procedure ◽  
Transfusion Therapy ◽  
Stroke Population ◽  
Clinical Classification Software ◽  
Inpatient Database

Background: Sickle cell disease (SCD) is an important risk factor for stroke in children. Natural history studies demonstrate that greater than 10% of hemoglobin SS patients suffered ischemic stroke prior to age 20 years. In 1998, the Stroke Prevention Trial in Sickle Cell Anemia (STOP) successfully demonstrated the role for routine transfusion therapy in reducing stroke in at risk SCD patients. Fullerton and colleagues then found that first time stroke in SCD decreased in Californian children in the 2 years following STOP. We investigated the stroke rate and health care utilization of children with SCD for two calendar years in the decade following publication of the STOP trial using a national inpatient database. Methods: The 2000 and 2009 Kids’ Inpatient Database (KID) were used for analysis. SCD and stroke cases were identified by ICD-9 codes 282.6x, 430, 431, 432.9, 434.X1, 434.9, 435.9. We queried the KID procedural clinical classification software for utilization of services pertinent to SCD and stroke; transfusion, MRI, and cerebral angio. Results: In 2000, SCD was a discharge diagnosis in 34,294 children and 158 (0.46%) children had SCD and stroke. By 2009, discharges with SCD rose to 37,082 children with 212 (0.57%) children carrying both diagnoses. In 2000 and 2009, AIS is the most common stroke type at 83%, males account for 53% of stroke and black race was reported by 92% of SCD and stroke subjects. Procedure utilization is higher in the SCD and stroke population than in SCD without stroke (Figure 1). Blood transfusion is the most common procedure in both study years, significantly higher in stroke subjects. Conclusion: For pediatric inpatients with SCD, blood transfusion and diagnostic cerebrovascular procedures were significantly more common in the cohort with comorbid stroke. In the decade after STOP, children hospitalized with SCD and stroke represented less than 0.6% of the total inpatient SCD population.

Pathophysiology of Hemorrhage as It Relates to the Warfighter

Physiology ◽  
2022 ◽  
Author(s):  
Carmen Hinojosa-Laborde ◽  
Ian L. Hudson ◽  
Evan Ross ◽  
Lusha Xiang ◽  
Kathy L. Ryan
Keyword(s):  
Blood Transfusion ◽  
Organ Failure ◽  
Oxygen Delivery ◽  
Multi Organ Failure ◽  
Care Situation

Saving lives of wounded military Warfighters often depends on the ability to resolve or mitigate the pathophysiology of hemorrhage, specifically diminished oxygen delivery to vital organs that leads to multi-organ failure and death. However, caring for hemorrhaging patients on the battlefield presents unique challenges that extend beyond applying a tourniquet and giving a blood transfusion, especially when battlefield care must be provided for a prolonged period. This review will describe these challenges and potential strategies for treating hemorrhage on the battlefield in a prolonged casualty care situation.

Retinal microvascular analysis using Fundus Fluorescein Angiography in Egyptian sickle cell disease patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nayera H El Sherif ◽  
Mahmoud A Kenny ◽  
Waheed S Elhalfawy
Keyword(s):  
Sickle Cell Disease ◽  
Blood Transfusion ◽  
Fluorescein Angiography ◽  
Sickle Cell ◽  
Large Sample Size ◽  
Cell Disease ◽  
Fundus Fluorescein Angiography ◽  
Transfusion Therapy ◽  
Hydroxyurea Treatment ◽  
Trans Cranial Doppler

Abstract Background Sickle cell disease can affect retina of eye via vaso-occulsive changes that occur in micro-vessels of retina which could be analysed by using Fundus Fluorescein Angiography. Aim To analyze macular microvascular alternation in patients with SCD by Fundus Fluorescein Angiography (FFA) and to assess the role of potentially contributory Clinico-pathological factors including Trans-Cranial Doppler, genotypes, hydroxyurea, transfusion therapy and finally iron overload state on the development of macular alterations. Method This was across-sectional study which included 30 Sickle cell disease patients randomly recruited from the Paediatric Haematology clinic, children Hospital, Ain Shams University, Cairo, Egypt. Complete blood count (CBC), Trans-Cranial Doppler (TCD) and Fundus Fluorescein Angiography. Results In our study, there were 30 patients with mean age (14.1± 4.02), 5 patients had abnormal/conditional Trans-Cranial, 15 patients had Vaso-occlusive crises, 11 patients were on regular simple blood transfusion; all 30 studied sickle cell disease patients had normal Fundus Fluorescein Angiography and eye examination and only one patient hadabnormal visual acuity;A 29 years oldgirl who had five attacks of cerebral strokes last year, on regular simple blood transfusion and Hydroxyurea treatment with abnormal TCD and recurrent Vaso-occlusive crises in last two years, Although her vision is hand movement yet Fundus Fluorescein Angiography was normal. Conclusion we didn’t find any Retinal microvascular alternation in our studied SCD patients using Fundus Fluorescein Angiography, we related our results to the fact that our studied SCD patients were young and all our studied patients were on hydroxyurea therapy with fair compliance, further studies using large sample size are warranted in order to illustrate the utility of Fundus Fluorescein Angiography (FFA) as a tool for better detection of sickle retinopathy.

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