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The effects of a unit of blood on a patient?

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JR32 View Drop Down
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  Quote JR32 Quote  Post ReplyReply bullet Topic: The effects of a unit of blood on a patient?
    Posted: Feb 05 2008 at 10:52am
I was wondering if anyone out there has any info or articles discussing the effect of putting on  a unit of Prbc's for a patient while on Cpb.  We notice our patients have a arterial pressure drop and vasodilate out. Our Doctor was wanting to know if any article discuss why and the effects it has on the patient.
                                                   
                                       Thanks jr28
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samolyk View Drop Down
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  Quote samolyk Quote  Post ReplyReply bullet Posted: Feb 05 2008 at 2:04pm
jr28 Check out this Link to a Downloadable PDF. http://www.pnas.org/cgi/reprint/0708160104v1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=transfusion&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
 
Look closely at the graphs of what changes take place in stored donor "allogeneic" blood. It will make you think twice before transfusing PRBC's and make you want to wash every unit before you put it in your pump!
 
Autologous Blood Conservation and blood product avoidance is the hotest topic in CV surgery today. If you learn as a team to manage blood better your outcomes will Improve dramatically.
 
 
Keith A. Samolyk CCP,LCP
Global Blood Resources LLC
P.O. Box 383 Somers, CT 06071
T(800)942-9243
F(860)763-7045
www.mybloodfirst.com
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racine View Drop Down
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  Quote racine Quote  Post ReplyReply bullet Posted: Feb 05 2010 at 6:11pm
Keith, the practice of washing bank blood prior to transfusion into the pump on CPB is a controversial one.  I posed this question to a pathologist and another physician affiliated with AABB at the Blood Mgt meeting in Wyoming a couple of years ago and both felt that though the practice seemed sound and possibly advantageous, there was just not any significant evidence to support the practice one way or another and that doing so places the practitioner in a liable position in the eyes of the AABB.  It may seem logical to many to do this and possibly as a no-brainer to others but I had to go with the recommendation of these two experts.  Do you know of any new data or studies in the last 2 years to support this practice?  If so can you elaborate?  It is clear to me the advantages of cell washing but it becomes "blood processing"  in the eyes of the AABB. 
Thanks,
Racine
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samolyk View Drop Down
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  Quote samolyk Quote  Post ReplyReply bullet Posted: Feb 08 2010 at 7:53am
Hello Racine,
 
Once blood is removed from the body it starts to change immediately and deteriorates (even platelets in ANH blood in hours). There is evidence out there that blood thats older than 10 days has negatively transformed enough that it can be implicated in morbidity.
 
Sensitive research and studies are forthcoming. I would check the www.SABM.org website for the papers. If you would like to contact me privately and discuss this topic my address is gbrllc@comcast.net
 
I look forward to hearing from you.
 
-Keith S.
  GBR  
 
Here is a few articles
 
 
 
 
 
 
 
 
 
 
Keith A. Samolyk CCP,LCP
Global Blood Resources LLC
P.O. Box 383 Somers, CT 06071
T(800)942-9243
F(860)763-7045
www.mybloodfirst.com
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racine View Drop Down
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  Quote racine Quote  Post ReplyReply bullet Posted: Feb 08 2010 at 4:05pm
Thanks for several good articles, some I've read previously.  What I'm pointing out though is the concept of actually washing a unit of PRBCs prior to transfusion.  While I agree in concept about the dual edged nature of blood in usage and that washing blood prior to use should be beneficial, it is just not something I see condoned or proposed by anyone at AABB.   Again it seems to them that doing so is considered "processing" and within the scope of practice of the blood bank and not of a perfusionist.  If you have data that is newer, that's what some of us would like to see.   My surgeons & pathologists agree in concept as well but would like to see any evidence before we can decide on it one way or another. 
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  Quote samolyk Quote  Post ReplyReply bullet Posted: Feb 08 2010 at 5:25pm
I know of 2 studies that underway right now but I have nothing for you that is Peer reviewed that is available right now.  The AABB which sets voluntary guidlines is in the business of processing donor blood for transfusion.  Your Surgeons are the captain of the ship during the case. This was a hot Topic at the "New Advances in Blood Mangement" in KC and will be presented again at the Jackson Hole Blood Management Meeting in August 14th-18th. So that's it
Keith A. Samolyk CCP,LCP
Global Blood Resources LLC
P.O. Box 383 Somers, CT 06071
T(800)942-9243
F(860)763-7045
www.mybloodfirst.com
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  Quote samolyk Quote  Post ReplyReply bullet Posted: Feb 11 2010 at 2:17pm

http://www.ncbi.nlm.nih.gov/pubmed/20025760

Keith A. Samolyk CCP,LCP
Global Blood Resources LLC
P.O. Box 383 Somers, CT 06071
T(800)942-9243
F(860)763-7045
www.mybloodfirst.com
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Warren View Drop Down
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  Quote Warren Quote  Post ReplyReply bullet Posted: Mar 16 2013 at 3:21am
I'm feeling very pleased to see some good response for the users.The transfusion of banked blood from a donor to a recipient is a liquid body part transplant. Through that transplant, the recipient's own immune scheme is altered for some time span of time.[11] In the medical world there is argument in regard to how long and how significant that immune suppression/alteration lasts; expected it lasts for weeks and perhaps up to years.
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