Red blood cells transfusion

Red Blood Cells. Red blood cells (RBC) transport and deUver oxygen and carbon dioxide between the tissues and lungs. Red blood cell transfusions iacrease the oxygen carrying capacity ia anemic patieats. 

Use of Packed Red Blood Cell Transfusions and Erythropoietin in Critically 111 Patients"... 

Recommendations in this section may change based on the results from the recent EPO-3 trial (epoetin alfa versus placebo). A difference in red blood cell transfusion rates was not observed between groups. Epoetin alpha therapy improved survival in trauma patients. Epoetin alfa did not have a measurable clinical benefit in medical/surgical non-trauma patients. Epoetin alpha therapy was associated with an increased thrombotic event rate, particularly in patients not receiving pharmacological deep vein thrombosis prophylaxis. 

Platelet transfusions are used to prevent hemorrhage. Patients with uncomplicated thrombocytopenia can be transfused when the platelet count falls below 10,000/pL (10 x 109/L). Patients who are either highly febrile or actively bleeding may require transfusions at higher levels. Red blood cell transfusions generally are not necessary for a hemoglobin concentration greater than 8 g/dL (80 g/L, 4.96 mmol/L). 

Nacharaju P, Boctor FN, Manjula BN et al (2005) Surface decoration of red blood cells with maleimidophenyl-polyethylene glycol facilitated by thiolation with iminothiolane an approach to mask A, B, and D antigens to generate universal red blood cells. Transfusion 45 374-383... 

Strauss, R. 2006. Controversies in the management of the anemia of prematurity using single-donor red blood cell transfusions and/or recombinant human erythropoietin. Transfusion Medicine Review 20(1), 34-44. 

An important overall approach for treatment of sepsis is goal-directed therapy. Mortality can be reduced by early placement and use of a central venous catheter, increased fluid volume administration, dobutamine therapy if needed, and red blood cell transfusion, to achieve specific physiologic goals in the first 6 hours. Evidence-based treatment recommendations for sepsis and septic shock from the Surviving Sepsis campaign are presented in Table 45-3. 

Despite all the advances in storing or distributing blood, providing life-saving red blood cell transfusions in disasters and on the battlefield remains a challenge because facilities are not readily available for cold storage of large quantities of red cells. Researchers have worked for decades to come up with a red blood cell substitute,... 

F. Role in therapy Epoetin alfa represents a major advance in the treatment of anemia associated with chronic renal failure. The hormone is an alternative to androgen and red blood cell transfusion therapy, which had been the mainstay of treatment. It may also provide an alternative for those patients who previously could not be treated with blood transfusions because of religious reasons. 

Hebert, P.C. Schweitzer, I. Calder, L. Blajchman, M. Giulivi, A. Review of the clinical practice literature on allogeneic red blood cell transfusion. Can. Med. Assoc. J. 1997,156 (Suppl 11), S9-S26. 

Goldfinger D, Lowe C. Prevention of adverse reactions to blood transfusion by the administration of saline-washed red blood cells. Transfusion 1981 21(3) 277-80. 

AOP is usually treated with red blood cell transfusions. Prema-tnre infants fed human milk need 2 mg/kg per day iron snpplemen-tation. EPO may be nsed in AOP, keeping in mind that EPO pharmacokinetics are inflnenced by the developmental age of the infant. EPO has limited efficacy in decreasing the reqnirement for transfn-sions, making it a controversial treatment approach. Infants on fnU enteral feedings treated with EPO need iron supplements in doses of 6 mg/kg per day. 

Harmatz P, Butensky E, Quirolo K, et al. Severity of iron overload in patients with sickle cell disease receiving chronic red blood cell transfusion therapy. Blood 2000 96 76-79. 

Haverly RM, Harrison CR, Dougherty TH. Yersinia enterocolitica bacteremia associated with red blood cell transfusion. Arch Pathol Lab Med 1996 120 499-500. 

Early goal-directed therapy of sepsis consisting of hemodynamic monitoring with a central venous catheter, volume resuscitation, inotropic therapy, and red blood cell transfusions demonstrated a significant clinical outcome benefit with a 16% absolute reduction in 28-day mortality. 

Weightman, W.M., Gibbs, N.M., Weidmann, C.R., Newman, M.A., Grey, D.E., Sheminant, M.R., and Erber, W.N. (2002) The Effect of Preoperative Aspirin-Free Interval on Red Blood Cell Transfusion Requirements in Cardiac Surgical Patients, J. Cardiothorac. Vasc.Anesth. 16,54—58. 

Shander A, Sazama K. Clinical consequences of iron overload from chronic red blood cell transfusions, its diagnosis, and its management by chelation therapy. Transfusion 2010 50(5) 1144—55. 

Severe combined immunodeficiency (SCID) due to adenosine deaminase deficiency (ADA) exhibits autosomal recessive inheritance, and may account for up to 209 of cases (l). Accumulation of intracellular toxic deoxynucleotides and/or S-adenosyl homocysteine particularly in T cells, is considered responsible for the severe lymphoid depletion and dysfunction observed in affected children (2). Unlike other forms of SCID, this variety is amenable to enzyme replacement therapy using regular fresh irradiated red blood cell transfusions as the source of enzyme. Another form of therapy suggested from in vitro studies, is the use of deoxycytidine which theoretically would act as a competitive substrate for deoxycytidine kinase, the enzyme considered responsible for the intracellular accumulation of deoxy-ATP (dATP). This study reports our experience of various treatments in three ADA deficient children. 

Red blood cell transfusion a clinical practice guideline from the AABB. Ann Intern Med 2012 157 49-58. 

Haematologic Topical benzocaine application continues to be a problem, as it may cause methaemoglobinaemia. Two cases have been again described in children aged 7 months and 6 years who had received topical benzocaine gel mixture (7.5% benzocaine including doxycycline, nystatin and glycerin) in the setting of postchemotherapy oral stomatitis treatment and who required hospitalisation and treatment (red blood cell transfusion and oral ascorbic acid in one case and methylene blue in the second) [29 ]. 

Infection risk A retrospective cohort study looked at the association of plasma transfusion with postoperative infectious complications after oesophageal resection siugery [41 ]. Plasma transfusions were associated with an increased risk of postoperative infection (OR=6.1, 95% C3=l.l-47.8 p=0.05). Interestingly, red blood cell transfusion was not associated with infectious complications. 

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