Plasma free hemoglobin and microcirculatory response to fresh or old blood transfusions in sepsis
| Autor: | Michele Maria Luchetti, Nicoletta Mininno, Rosella Bencivenga, Daniele Strovegli, Elisa Damiani, Abele Donati, Rocco Romano, Andrea Carsetti, Can Ince, Erica Adrario, Paolo Pelaia, Claudia Scorcella, T Principi, Silvia Pierantozzi, Armando Gabrielli |
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| Přispěvatelé: | Amsterdam Cardiovascular Sciences, Translational Physiology |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion medicine.medical_treatment Hemodynamics lcsh:Medicine Gastroenterology Microcirculation Nitric oxide Sepsis chemistry.chemical_compound Hemoglobins Internal medicine Blood plasma medicine Humans Blood Transfusion lcsh:Science Aged Multidisciplinary business.industry Pulmonary Gas Exchange lcsh:R Middle Aged medicine.disease Surgery chemistry Microvessels Free hemoglobin Female lcsh:Q medicine.symptom business Vasoconstriction Research Article |
| Zdroj: | PLoS ONE, Vol 10, Iss 5, p e0122655 (2015) PLoS ONE, 10(5). Public Library of Science PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Free hemoglobin (fHb) may induce vasoconstriction by scavenging nitric oxide. It may increase in older blood units due to storage lesions. This study evaluated whether old red blood cell transfusion increases plasma fHb in sepsis and how the microvascular response may be affected. Methods This is a secondary analysis of a randomized study. Twenty adult septic patients received either fresh or old (15 days storage, respectively) RBC transfusions. fHb was measured in RBC units and in the plasma before and 1 hour after transfusion. Simultaneously, the sublingual microcirculation was assessed with sidestream-dark field imaging. The perfused boundary region was calculated as an index of glycocalyx damage. Tissue oxygen saturation (StO2) and Hb index (THI) were measured with near-infrared spectroscopy and a vascular occlusion test was performed. Results Similar fHb levels were found in the supernatant of fresh and old RBC units. Despite this, plasma fHb increased in the old RBC group after transfusion (from 0.125 [0.098–0.219] mg/mL to 0.238 [0.163–0.369] mg/mL, p = 0.006). The sublingual microcirculation was unaltered in both groups, while THI increased. The change in plasma fHb was inversely correlated with the changes in total vessel density (r = -0.57 [95% confidence interval -0.82, -0.16], p = 0.008), De Backer score (r = -0.63 [95% confidence interval -0.84, -0.25], p = 0.003) and THI (r = -0.72 [95% confidence interval -0.88, -0.39], p = 0.0003). Conclusions Old RBC transfusion was associated with an increase in plasma fHb in septic patients. Increasing plasma fHb levels were associated with decreased microvascular density. Trial Registration ClinicalTrials.gov NCT01584999 |
| Databáze: | OpenAIRE |
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