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Transfusion Hemolysis

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1. Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer's chase technique - a randomized pilot study. (PubMed)

Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer's chase technique - a randomized pilot study. Residual pump blood from the cardiopulmonary bypass (CPB) circuit is often collected into an infusion bag (IB) and re-transfused. An alternative is to chase the residual blood into the circulation through the arterial cannula with Ringer's acetate. Our aim was to assess possible differences in hemostatic blood quality between these two (...) techniques.Forty adult patients undergoing elective coronary artery bypass graft surgery with CPB were randomized to receive the residual pump blood by either an IB or through the Ringer's chase (RC) technique. Platelet activation and function (impedance aggregometry), coagulation and hemolysis variables were assessed in the re-transfused blood and in the patients before, during and after surgery. Results are presented as median (25-75 quartiles).Total hemoglobin and platelet levels in the re-transfused blood

2018 Perfusion

2. Mechanical hemolysis in pediatric patients associated with rapid transfusion and one-way valve. (PubMed)

Mechanical hemolysis in pediatric patients associated with rapid transfusion and one-way valve. Four similar transfusion reactions involving infants were reported in less than 1 year. After transfusion of red blood cells (RBCs) via syringe in the operating room, each patient experienced discolored urine, laboratory evidence of hemolysis, and acute kidney injury. Clerical and serologic investigations were unremarkable. Mechanical hemolysis was considered.Simulated syringe transfusions were (...) performed. Measurements included hematocrit (Hct), free hemoglobin, and visual hemolysis index. Washed and unwashed RBCs were tested with or without a recently introduced one-way valve, using a 24- or 16-gauge intravenous catheter. Constant manual pressure (1.43 ± 0.49 mL/sec) or syringe pump (2 mL/min) was used and a subset was timed.The valve increased hemolysis during manual transfusion using both catheters with washed and unwashed RBCs. With the 24-gauge catheter, the change in Hct was -3.53 ± 0.69

2018 Transfusion

3. Soluble antigens in plasma allow mismatched transfusion without hemolysis. (PubMed)

Soluble antigens in plasma allow mismatched transfusion without hemolysis. Universal plasma is a scarce resource when a massive transfusion protocol has been initiated. Previous studies have reported success using group A plasma in place of the universal plasma, group AB. It is unclear why there are not more reports of hemolytic reactions occurring from this practice. One possible explanation is the presence of water-soluble antigens in the patient plasma that bind to, and neutralize (...) . This protective effect is revealed with the paucity of intravascular hemolysis observed in these out-of-group massive transfusions.© 2018 AABB.

2018 Transfusion

4. Severe hemolysis and transfusion reactions after treatment with BGB-3111 and PD-1 antibody for Waldenström macroglobulinemia (PubMed)

Severe hemolysis and transfusion reactions after treatment with BGB-3111 and PD-1 antibody for Waldenström macroglobulinemia 29439186 2019 03 06 1592-8721 103 5 2018 05 Haematologica Haematologica Severe hemolysis and transfusion reactions after treatment with BGB-3111 and PD-1 antibody for Waldenström macroglobulinemia. e223-e225 10.3324/haematol.2017.186817 Othman Jad J Department of Haematology, Concord Repatriation General Hospital, Sidney, Australia. Verner Emma E Department

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2018 Haematologica

5. Hemolysis risk after packed red blood cells transfusion with infusion pumps (PubMed)

Hemolysis risk after packed red blood cells transfusion with infusion pumps To evaluate the hemolysis biomarkers of packed red blood cells transfused by two different linear peristaltic infusion pumps at two infusion rates.An experimental and randomized study was designed simulating the clinical practice of transfusion. Two linear peristaltic infusion pumps from different manufactures were studied in triplicate at 100 mL/h and 300mL/h infusion rates. The chosen hemolysis biomarkers were total (...) hemoglobin, free hemoglobin, hematocrit, potassium and degree of hemolysis. They were analyzed before and after each infusion.Potassium showed statistically significant variations in all scenarios of the experiment (P<0.010). In a separated analysis, potassium increased mainly at 300mL/h rate (P=0.021) and free hemoglobin had significant variation when comparing infusion pumps from different manufacturers (P=0.026). Although hematocrit, total hemoglobin and degree of hemolysis had increased after

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2018 Revista latino-americana de enfermagem

6. Discriminating complement-mediated acute transfusion reaction for type O+ red blood cells transfused into a B+ recipient with the complement hemolysis using human erythrocytes (CHUHE) assay. (PubMed)

Discriminating complement-mediated acute transfusion reaction for type O+ red blood cells transfused into a B+ recipient with the complement hemolysis using human erythrocytes (CHUHE) assay. A patient with B+ sickle cell disease received 3 units of red blood cells (RBCs) from two O+ donors and developed fever and hypotension after the first unit, consistent with an acute transfusion reaction (ATR). Anti-B titers in plasma from each O+ donor were markedly elevated and nondiscriminatory. In order (...) to evaluate the potential for the transfused units to produce complement-mediated hemolysis of B+ RBCs, hemolytic complement testing was performed.Plasma from each donor was diluted in veronal buffer and incubated with B+ RBCs, and free hemoglobin was measured by spectrophotometer in the complement hemolysis using human erythrocytes (CHUHE) assay. Peptide inhibitor of complement C1 (PIC1) was used to confirm antibody-initiated complement pathway activation.A 96-fold difference (p = 0.014) in hemolysis

2016 Transfusion

7. Expediting red blood cell transfusions by syringing causes significant hemolysis. (PubMed)

Expediting red blood cell transfusions by syringing causes significant hemolysis. Techniques commonly used to expedite blood transfusions include pneumatically pressurizing red blood cell (RBC) bags or manual syringing its contents. We compared these techniques on RBC hemolysis using a simulated transfusion model.Fifteen warmed RBC units that were 12.3 ± 4.3 (95% confidence interval [CI], 10.1-14.5) days old were each subjected to two experimental rapid transfusion techniques. RBCs from each (...) concentrations. Pressurizing RBC bags induced no more hemolysis than after gravity-facilitated transfusions. Syringing to expedite RBC transfusions should be avoided in favor of pneumatic RBC bag pressurization.© 2017 AABB.

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2017 Transfusion

8. Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants. (PubMed)

Effect of red blood cell storage time on markers of hemolysis and inflammation in transfused very low birth weight infants. BackgroundProlonged storage of transfused red blood cells (RBCs) is associated with hemolysis in healthy adults and inflammation in animal models. We aimed to determine whether storage duration affects markers of hemolysis (e.g., serum bilirubin, iron, and non-transferrin-bound iron (NTBI)) and inflammation (e.g., interleukin (IL)-8 and monocyte chemoattractant protein (...) in the other analytes were observed.ConclusionTransfusion of RBCs into VLBW infants is associated with increased markers of hemolysis and the inflammatory chemokine MCP-1. RBC-storage duration only correlated with increases in NTBI levels following transfusion. NTBI was only observed in healthy adults following 35 days of storage; however, this study suggests that VLBW infants are potentially more susceptible to produce this pathological form of iron, with increased levels observed after transfusion

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2017 Pediatric Research

9. Severe hemolysis after plasma transfusion in a neonate with necrotizing enterocolitis, Clostridium perfringens infection, and red blood cell T-polyagglutination. (PubMed)

Severe hemolysis after plasma transfusion in a neonate with necrotizing enterocolitis, Clostridium perfringens infection, and red blood cell T-polyagglutination. Red blood cell (RBC) Thomsen-Friedenreich antigen exposure (T activation) in infants with necrotizing enterocolitis (NEC) has occasionally been associated with posttransfusional intravascular hemolysis thought to be due to anti-T antibodies in the donor plasma.We describe an infant with NEC and Clostridium perfringens infection (...) complicated by severe hemolysis after plasma transfusion. After this case, infants with confirmed NEC were prospectively evaluated for T activation. We checked for hemolysis in patients with T activation receiving plasma-containing blood products.The infant had received 80 mL of fresh-frozen plasma (FFP). His RBCs displayed strong T activation, and agglutination was observed with four of six ABO-compatible FFP units. A direct antiglobulin test was negative. IgM-class anti-T antibodies were present

2017 Transfusion

10. Pressure Infusion Cuff and Blood Warmer during Massive Transfusion: An Experimental Study About Hemolysis and Hypothermia. (PubMed)

Pressure Infusion Cuff and Blood Warmer during Massive Transfusion: An Experimental Study About Hemolysis and Hypothermia. Blood warmers were developed to reduce the risk of hypothermia associated with the infusion of cold blood products. During massive transfusion, these devices are used with compression sleeve, which induce a major stress to red blood cells. In this setting, the combination of blood warmer and compression sleeve could generate hemolysis and harm the patient. We conducted (...) this study to compare the impact of different pressure rates on the hemolysis of packed red blood cells and on the outlet temperature when a blood warmer set at 41.5°C is used.Pressure rates tested were 150 and 300 mmHg. Ten packed red blood cells units were provided by Héma-Québec and each unit was sequentially tested.We found no increase in hemolysis either at 150 or 300 mmHg. By cons, we found that the blood warmer was not effective at warming the red blood cells at the specified temperature. At 150

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2016 PLoS ONE

11. Red Cell Transfusion-Associated Hemolysis in Cardiac Surgery: An Observational Cohort Study. (PubMed)

Red Cell Transfusion-Associated Hemolysis in Cardiac Surgery: An Observational Cohort Study. Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in susceptible patients, such as those undergoing cardiac surgery with cardiopulmonary bypass. To explore this hypothesis, we assessed the relationship of red (...) cell transfusions with cell-free hemoglobin and transferrin saturation levels in a consecutive cohort of cardiac surgical patients.Laboratory measures of hemolysis were obtained in consecutive cardiac surgical patients 15 to 30 minutes after bypass. Multivariable regression models controlling for important confounders were constructed to determine the independent relationship of red cell transfusions during bypass with cell-free hemoglobin and transferrin saturation levels post-bypass, analyzed

2017 Anesthesia and Analgesia

12. Sickle Cell Trait Increases Red Blood Cell Storage Hemolysis and Post-Transfusion Clearance in Mice (PubMed)

Sickle Cell Trait Increases Red Blood Cell Storage Hemolysis and Post-Transfusion Clearance in Mice Transfusion of blood at the limits of approved storage time is associated with lower red blood cell (RBC) post-transfusion recovery and hemolysis, which increases plasma cell-free hemoglobin and iron, proposed to induce endothelial dysfunction and impair host defense. There is noted variability among donors in the intrinsic rate of storage changes and RBC post-transfusion recovery, yet genetic (...) determinants that modulate this process are unclear.We explore RBC storage stability and post-transfusion recovery in murine models of allogeneic and xenogeneic transfusion using blood from humanized transgenic sickle cell hemizygous mice (Hbatm1PazHbbtm1TowTg(HBA-HBBs)41Paz/J) and human donors with a common genetic mutation sickle cell trait (HbAS).Human and transgenic HbAS RBCs demonstrate accelerated storage time-dependent hemolysis and reduced post-transfusion recovery in mice. The rapid post

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2016 EBioMedicine

13. Sternal Intraosseous Transfusion of Autologous Whole Blood: A Comparison of Flow Rates and Degree of Hemolysis

Sternal Intraosseous Transfusion of Autologous Whole Blood: A Comparison of Flow Rates and Degree of Hemolysis Sternal Intraosseous Transfusion of Autologous Whole Blood: A Comparison of Flow Rates and Degree of Hemolysis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Sternal Intraosseous Transfusion of Autologous Whole Blood: A Comparison of Flow Rates and Degree of Hemolysis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02924792 Recruitment Status : Completed First Posted : October 5, 2016 Last

2016 Clinical Trials

14. Transfusion Hemolysis

Transfusion Hemolysis Transfusion Hemolysis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Transfusion Hemolysis Transfusion (...) Hemolysis Aka: Transfusion Hemolysis , Immune Transfusion Reaction , Hemolytic Transfusion Reaction From Related Chapters II. Epidemiology : Up to 5 per 50,000 transfusions ABO incompatible transfusions are rare (213 events, and 24 deaths between 1996 and 2007) III. Types Intravascular Major incompatibility: ABO Immediate and massive Extravascular Minor incompatibility: Rh, xKell, xDuffy, xKid Delayed RBC destruction in reticuloendothelial IV. Signs: Intravascular Hemolysis (Major Incompatibility) Rapid

2018 FP Notebook

15. Prolonged red cell storage before transfusion increases extravascular hemolysis (PubMed)

Prolonged red cell storage before transfusion increases extravascular hemolysis Some countries have limited the maximum allowable storage duration for red cells to 5 weeks before transfusion. In the US, red blood cells can be stored for up to 6 weeks, but randomized trials have not assessed the effects of this final week of storage on clinical outcomes.Sixty healthy adult volunteers were randomized to a single standard, autologous, leukoreduced, packed red cell transfusion after 1, 2, 3, 4, 5 (...) , or 6 weeks of storage (n = 10 per group). 51-Chromium posttransfusion red cell recovery studies were performed and laboratory parameters measured before and at defined times after transfusion.Extravascular hemolysis after transfusion progressively increased with increasing storage time (P < 0.001 for linear trend in the AUC of serum indirect bilirubin and iron levels). Longer storage duration was associated with decreasing posttransfusion red cell recovery (P = 0.002), decreasing elevations

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2016 The Journal of clinical investigation

16. Ethnicity, sex, and age are determinants of red blood cell storage and stress hemolysis: results of the REDS-III RBC-Omics study (PubMed)

Ethnicity, sex, and age are determinants of red blood cell storage and stress hemolysis: results of the REDS-III RBC-Omics study Genetic polymorphisms in blood donors may contribute to donor-specific differences in the survival of red blood cells (RBCs) during cold storage and after transfusion. Genetic variability is anticipated to be high in donors with racial admixture from malaria endemic regions such as Africa and Asia. The purpose of this study was to test the hypothesis that donor (...) was strongly associated with increased susceptibility to all 3 hemolysis measures (P < .0001). African American background was associated with resistance to osmotic hemolysis compared with other racial groups (adjusted P < .0001). Donor race/ethnicity was also associated with extreme (>1%) levels of storage hemolysis exceeding US Food and Drug Administration regulations for transfusion (hemolysis >1% was observed in 3.51% of Asian and 2.47% of African American donors vs 1.67% of white donors

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2017 Blood advances

17. Hemolysis and blood infusion pumps for patients receiving blood or blood components: standards and evidence-based guidelines: standards and evidence-based guidelines

' conclusions No relevant health technology assessments, systematic reviews, or evidence-based guidelines were identified regarding acceptable levels of hemolysis caused by blood infusion pumps. References of potential interest are provided in the appendix. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Blood Transfusion; Equipment Design; Hemolysiss; Infusions, Parenteral Language Published English Country of organisation Canada Province or state Ontario English summary (...) Hemolysis and blood infusion pumps for patients receiving blood or blood components: standards and evidence-based guidelines: standards and evidence-based guidelines Hemolysis and blood infusion pumps for patients receiving blood or blood components: standards and evidence-based guidelines: standards and evidence-based guidelines Hemolysis and blood infusion pumps for patients receiving blood or blood components: standards and evidence-based guidelines: standards and evidence-based guidelines

2014 Health Technology Assessment (HTA) Database.

18. Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about?

normalizing. Reticulocyte count is 45. There are no signs of bleeding clinically or on ultrasound examination of the abdomen. There is no laboratory evidence of hemolysis. You suspect the patient may be unable to produce adequate RBCs due to inflammation from her injuries and operation. To be safe you send investigations to check nutritional parameters and start folic acid empirically. The patient complains of fatigue and you decide a blood transfusion is indicated. The situation is no longer emergent (...) Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? - CanadiEM Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about? In , by Matthew Nicholson July 30, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert, Communicator

2018 CandiEM

19. Red Blood Cell Transfusion in Patients With Autoantibodies: Is It Effective and Safe Without Increasing Hemolysis Risk? (PubMed)

Red Blood Cell Transfusion in Patients With Autoantibodies: Is It Effective and Safe Without Increasing Hemolysis Risk? The therapeutic efficacy of red blood cell (RBC) transfusions in patients with autoimmune hemolytic anemia (AIHA) is highly debated because of speculations on the increased risk of transfusion reactions; yet it is a suggested adjuvant therapy in anemic patients with life-threatening hypoxemia. In this study, we evaluated the safety and efficacy of RBC transfusions in AIHA (...) (P<0.001) in severe anemia (<5 g/dL) than in other patients.Transfusion of the least-incompatible RBCs in AIHA patients is effective and safe without any associated increase in hemolysis risk when compared with post-transfusion patients positive for alloantibodies or those lacking RBC-specific antibodies.

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2015 Annals of laboratory medicine

20. Red blood cell transfusion is associated with increased hemolysis and an acute phase response in a subset of critically ill children. (PubMed)

Red blood cell transfusion is associated with increased hemolysis and an acute phase response in a subset of critically ill children. In healthy adults, transfusion of older stored red blood cells (RBCs) produces extravascular hemolysis and circulating non-transferrin-bound iron. In a prospective, observational study of critically ill children, we examined the effect of RBC storage duration on the extent of hemolysis by comparing laboratory measurements obtained before, and 4 hr after, RBC (...) transfusion (N = 100) or saline/albumin infusion (N = 20). Transfusion of RBCs stored for longer than 4 weeks significantly increased plasma free hemoglobin (P < 0.05), indirect bilirubin (P < 0.05), serum iron (P < 0.001), and non-transferrin-bound iron (P < 0.01). However, days of storage duration poorly correlated (R(2) <0.10) with all measured indicators of hemolysis and inflammation. These results suggest that, in critically ill children, most effects of RBC storage duration on post-transfusion

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2015 American journal of hematology

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