Red blood storage lesion and cardiac surgery patients

Postgraduate Thesis uoadl:2776365 331 Read counter

Unit:
ΠΜΣ Θρόμβωση-Αιμορραγία-Ιατρική των Μεταγγίσεων
Library of the School of Health Sciences
Deposit date:
2018-07-03
Year:
2018
Author:
Chantzi Charikleia
Supervisors info:
Μανιάτη Αλίκη, Ομότιμη Καθηγήτρια, Ιατρική, Πανεπιστήμιο Πατρών
Πολίτου Μαριάννα, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Βαλσάμη Σερένα, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Αποθηκευτική βλάβη των ερυθρών και καρδιοχειρουργημένοι ασθενείς
Languages:
Greek
Translated title:
Red blood storage lesion and cardiac surgery patients
Summary:
Red blood cells are the most commonly used blood component, which are used for transfusions throughout the World (Carson et al. 2012). Are usually stored for 42 days and the anticoagulant solutions consists of citrate, dextrose, phosphate and adenine (Adams et al. 2015). In the human body, they are generally removed from the circulation by 2 distinct mechanisms. These are the red blood cell ageing and senescence (Bogdanova and Lutz 2013). These mechanisms are characterized by progressive loss of surface area also called membrane loss and reduced metabolism.
The Red Blood Cell Storage Lesion is generally referred to the changes that occur due to the ageing of the red blood cells while in storage solutions (Sut et al. 2017). Oxidative stress forms an important part of red blood cell storage lesion formation. This results in protein oxidation, lipid peroxidation and decreased integrity of the membranes of the red blood cells. These in turn contribute to the formation of microparticles (or microvescicles} that results in the increased risk of post transfusion complications (Huyut et al. 2016). Other changes that occur as a result RBC storage lesion are lactic acid, potassium and calcium accumulation, decrease in the levels of ATP and 2, 3-DPG, decrease in the rate of glycolysis, decrease in pH (García-Roa et al. 2017).
The presence of red blood cell lesions in the components of the stored blood results in adverse events in patients receiving blood transfusions. (Sahu and Hemlata 2014). These include postoperative infections, multiple organ failure, prolonged mechanical ventilation, increased hospital stay of patients and even death (Cholette et al. 2015).These adverse outcomes are generally observed in patients in intensive care or those who have undergone cardiac interventions, colorectal surgery or multiple traumas. (Lelubre and Vincent 2013).
There are several studies which have evaluated the storage time of red blood cells and clinical outcomes for cardiac surgery patients. In the main study of literature, storage lesions were considered in the case of patients who had undergone off-pump coronary artery bypass surgery. This study found that longer storage of red blood cells was associated with longer hospital stays, increased incidence of postoperative wound complications and a negative base excess within patients. Another study was conducted to consider the outcomes of pediatric cardiac patients undergoing open heart surgery. Different clinical outcomes were observed, including patient’s RBC requirement, CRP (inflammation) measure and use of ventilation machine length.
From the two studies evaluated there is tangible evidence indicating the effect of storage lesions on clinical outcomes for cardiac surgery patients. Specifically, patients who have received fresher units of red blood cells often have better clinical outcomes in terms of their hospital stay durations, the durations of using ventilation machines, their transfusion unit requirement as well as negative base levels and inflammation levels. Using fresher units of red blood results in lower incidences of postoperative wound complications.
Main subject category:
Health Sciences
Keywords:
Red blood storage lesion, Adverse clinical effects, Cardiac surgeric patients
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
103
Number of pages:
62
File:
File access is restricted only to the intranet of UoA.

Xantzi Xarikleia Master.pdf
2 MB
File access is restricted only to the intranet of UoA.