Blood Components Research Articles

Spontaneous hepatic rupture in pregnancy with initial intrapartum cholestasis of pregnancy

Spontaneous hepatic rupture in pregnancy or the puerperium is an extremely rare and life-threatening condition. We present a case in which the patient initially presented with intrahepatic cholestasis of pregnancy and shortly after delivery developed acute spontaneous hepatic rupture. Unlike most other cases, the patient never developed a fulminant syndrome of hemolysis, elevated liver enzymes and low platelet count (HELLP). Early recognition of the syndrome, an aggressive surgical approach with cesarean section and liver packing and blood component therapy contributed to a successful outcome and admission of 27 days.

IS THERE ANY SIGNIFICANT IMPACT OF TWO DIFFERENT BIO-COMPATIBLE COATED CARDIOPULMONARY BYPASS CIRCUITS ON CIRCULATING PLATELET DROP

Bleeding is common in cardiopulmonary bypass (CPB) surgery due to malfunctioning platelets. This study investigated the effect of a phosphorylcholine (PC)-coated CPB circuit and a balanced CPB circuit on platelet function. We conducted a descriptive, randomized trial at the Punjab Institute of Cardiology with 50 patients undergoing coronary artery bypass graft (CABG) surgery (n=34), valve surgery (n=10), and CABG plus valvular replacement (n=6) using CPB. The patients were divided into groups 1, which had phosphoryl-coated CPB, and 2, which had balanced-coated CPB. We measured and recorded pre- operative and post-operative levels of platelet count, white blood cells, and hemoglobin for both groups. We used the Student's t- test to make comparisons among groups, and the P values for both groups were less than 0.05 at a 95% confidence interval, indicating a significant impact of biocompatible coated CPB circuits on circulating platelet drop. Cohen's d formula showed that group 1 (Phosphoryl choline coating) had a more substantial effect on platelet drop than group 2 (Balanced coating). Blood component conservation, particularly platelet conservation, depends on the non-endothelium biocompatible surface used; the better the character, the more blood cells may be conserved. We looked at two coatings, phosphoryl coating, and balanced coating, to see if they substantially influenced platelet drop. According to the findings of our investigation, phosphoryl-coated CPB had a more significant influence on platelet drop than balanced coating.

RELATIONSHIP OF PROTEIN INPUT, VITAMIN C, FE WITH BLOOD COMPONENTS (HB, LEUKOSITES, AND HEMATOCRITES) IN SOCCER ATHLETES AT PPLP MEDAN

Football is an achievement sport and widely played throughout the world by all age groups, races and genders. Minerals and vitamins are nutrients that football athletes should consume because they contain antioxidants that can neutralize oxidative stress. Meanwhile, protein functions as an antibody and replaces cells damaged due to injuries experienced by a soccer athlete. This study aims to determine the relationship between protein intake, vitamin C, Fe and blood components (Hb, leukocytes and hematocrit) on football athletes at PPLP Medan. This study using descriptive observational with design cross sectional , that isanalyze the relationship between protein intake, vitamin C, Fe and blood components (Hb, leukocytes, and hematocrit) football athlete (PPLP) Medan . The entire population was sampled, totaling 33 people, both core and reserve players. Protein, vitamin C and Fe intake were significantly related to Hb p- value 0.05. Meanwhile, protein and Fe intake were significantly related to hematocrit, while vitamin C was not related (p- value 0.05). Meanwhile, protein and vitamin C intake was significantly related to leukocytes, but Fe was not (p- value 0.05). There is a relationship between protein, Fe and vitamin C intake with hemoglobin levels based on the Pearson correlation statistical test analysis . There is a relationship between Protein and Fe intake and hematocrit based on the Pearson correlation statistical test analysis. There is a relationship between protein and vitamin C intake with leukocytes based on the Pearson correlation statistical test analysis.

Resistance training and hematological responses

Aplastic anemia is a hematopoietic dysfunction that compromises pluripotent cells; the phenomenon that gives rise to the multiplication and maturation of the precursor or primordial cells of blood cells. It is commonly treated with immunosuppressive therapy and/or halogenic bone marrow transplantation. However, despite the comorbidities of aplastic anemia, studies associating physiological changes related to regular physical exercise are still scarce, possibly due to the low prevalence of the disease. Thus, we describe here the impact of a resistance training program on different hematological markers in a patient with severe aplastic anemia. A 39-year-old white male diagnosed with aplastic anemia 22 years ago underwent 12 weeks of resistance training. Different hematological markers were analyzed before and after 7 and 12 weeks of intervention. After the intervention an increase in reticulocytes and several other blood components were observed, the values of which remained within normal limits. In addition, there was a reduction in transaminases and liver enzymes that mark canalicular lesions, proving an improved liver condition. We conclude that after 12 weeks of strength training the patient presented positive changes in different hematological markers, such as erythrocytes, hemoglobin, hematocrit, neutrophils, and leukocytes, suggesting a positive effect of resistance training on the patient's clinical picture associated with the natural course of disease treatment.

Endothelial cell dysfunction in cardiac disease: driver or consequence?

The vascular endothelium is a multifunctional cellular system which directly influences blood components and cells within the vessel wall in a given tissue. Importantly, this cellular interface undergoes critical phenotypic changes in response to various biochemical and hemodynamic stimuli, driving several developmental and pathophysiological processes. Multiple studies have indicated a central role of the endothelium in the initiation, progression, and clinical outcomes of cardiac disease. In this review we synthesize the current understanding of endothelial function and dysfunction as mediators of the cardiomyocyte phenotype in the setting of distinct cardiac pathologies; outline existing in vivo and in vitro models where key features of endothelial cell dysfunction can be recapitulated; and discuss future directions for development of endothelium-targeted therapeutics for cardiac diseases with limited existing treatment options.

Studies on temperature-dependent bandgap and gap-to-midgap ratio in diamond lattice photonic crystal with biosensing applications

The present study examines the temperature dependence of the photonic bandgap, the corresponding wavelength and the gap-to-midgap ratio in a three-dimensional diamond lattice photonic crystal. The bandgap calculations establish that the structure shows a complete photonic bandgap centered around 1550 nm at 300 K. The thermo-optic effect, observed in silicon, is employed to compute the photonic bandgap, band-edge wavelengths and mid-bandgap wavelength at various temperatures in the range of 300 K–400 K. The gap-to-midgap ratio, for the proposed structure, is also evaluated at different temperatures. It is seen that the upper and lower band-edge wavelengths and the mid-bandgap wavelength show a linear temperature dependence. The sensitivity of the structure is observed to be 0.0518 nm/K, thus supporting temperature sensing applications. It is found that the gap-to-midgap ratio, for the proposed diamond lattice structure, shows linear variation with temperature. The effect of variation of the dielectric constant and the fill factor on the gap-to-midgap ratio for the diamond structure has also been analyzed. The proposed design has also been analyzed as a refractive index sensor with a sensitivity of 254.9 nm/RIU for sensing the different components of blood.

A Korean family with RHD*DNT only detectable after anti-D alloimmunization.

Identification of DNT, a rare partial D, can be challenging, as it is difficult to distinguish from D+. This study aimed to identify DNT individuals by analyzing the DNT proband's family members, characterize DNT, and propose management strategies. Family members of the first Korean DNT proband were recruited. RHD genotyping was conducted, and weak D tests were carried out using several anti-D reagents. Three DNT individuals were identified among 6 family members, including 1 with an anti-D alloantibody. As DNT red cells exhibited strong reactivity with all anti-D clones, DNT was serologically indistinguishable from D+. Moreover, unusual serologic findings in DNT individuals only became apparent after anti-D alloimmunization. We recommend DNT individuals as candidates for Rh immune globulin prophylaxis during the perinatal period and transfusions with D- blood components. An anticipatory RHD genotyping is suggested for partial D family members to prevent potential partial D individuals from becoming alloimmunized.

Design of a highly sensitive cascaded rectangular ring resonator embedded with gold nanorods and gratings for multipurpose application

This study introduces a sensor consisting of a metal-insulator-metal (MIM) structure, having an integration of gold nanorods and gratings, to perform various functions including sensing refractive index, detecting blood components, monitoring temperature, and measuring magnetic fields. The sensor's spectral properties are studied analytically in the MIR region implementing finite element method. Furthermore, the potential in the RI sensing is extensively examined by modulating the geometrical parameters, ultimately establishing a direct relationship with the transmittance profile. Following computational experiments, the best possible configuration exhibits the maximum sensitivity of 6118.685 nm/RIU. This research shows the biosensing applications by the detection of near-infrared and visible blood components such RBC, Hb, WBC, plasma, and water with a high sensitivity of 3185.05 nm/RIU. Moreover, ethanol is employed to evaluate the proffered sensor's temperature sensing feature and a maximum sensitivity 1.18 nm/°C was attained. Furthermore, this sensor can be used for magnetic field detection as it shows a high magnetic field sensitivity of 354.66 pm/Oe. The structural model is simple. Besides, this design has the potential to serve as a substitute for sensors that rely on silver. It is chemically stable and performs well in refractive index measurement, biosensing, temperature sensing and magnetic field detection.

Peculiarities of adaptational changes in leukocytes and platelets of yakutian ground squirrels during the pre-hibernation period in autumn

Earlier, it was shown that a series of physiological and biochemical changes in Yakutian long-tailed ground squirrels start to happen during autumn (the pre-hibernation period): in the brain, heart, skeletal muscles, etc. This study was conducted to analyze the composition of peripheral blood cells obtained from Yakutian ground squirrels in autumn, and for the first time an increase in the total number of leukocytes, particularly granulocytes, and a decrease in the number of lymphocytes were observed when compared with those obtained in summer; a shift of the leukogram from the lymphocytic fraction to the granulocytic fraction was revealed. Significant increase in a platelet count and thrombocrit with preservation of the percentage ratio of mature and young cell fractions was shown. Still, information on the cellular components of blood during the autumn season when hibernators prepare for winter months of hibernation remains scarce. Nonetheless, the results of our study indicate that there are very significant adaptive changes that occur in leukocytes and platelets of ground squirrels in this period. Possible causes of these changes are discussed.

Medication Deferrals in Blood Donors

Medication use is extremely common in blood donors. Blood centers use various methods to obtain a history of medication use, all of which have strengths and weaknesses. Some data are available to develop policies for medications that impact product quality, transmissible disease testing, and infectious risks. Many blood centers defer donors for use of a small number of highly teratogenic medications, as a precautionary measure. Others also defer for possible harms related to the pharmacologic effects of medications. However, a single exposure to a blood component containing medication, with immediate dilution in the recipient's blood stream, is a very different situation from ongoing use of medication in a patient, with steady state concentrations achieved over time. It is therefore highly unlikely that these effects are relevant for recipient safety.

Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury

Critical bleeding is associated with a high mortality rate in patients with trauma. Hemorrhage is exacerbated by a complex derangement of coagulation, including an acute fibrinogen deficiency. Management is fibrinogen replacement with cryoprecipitate transfusions or fibrinogen concentrate, usually administered relatively late during hemorrhage. To assess whether survival could be improved by administering an early and empirical high dose of cryoprecipitate to all patients with trauma and bleeding that required activation of a major hemorrhage protocol. CRYOSTAT-2 was an interventional, randomized, open-label, parallel-group controlled, international, multicenter study. Patients were enrolled at 26 UK and US major trauma centers from August 2017 to November 2021. Eligible patients were injured adults requiring activation of the hospital's major hemorrhage protocol with evidence of active hemorrhage, systolic blood pressure less than 90 mm Hg at any time, and receiving at least 1 U of a blood component transfusion. Patients were randomly assigned (in a 1:1 ratio) to receive standard care, which was the local major hemorrhage protocol (reviewed for guideline adherence), or cryoprecipitate, in which 3 pools of cryoprecipitate (6-g fibrinogen equivalent) were to be administered in addition to standard care within 90 minutes of randomization and 3 hours of injury. The primary outcome was all-cause mortality at 28 days in the intention-to-treat population. Among 1604 eligible patients, 799 were randomized to the cryoprecipitate group and 805 to the standard care group. Missing primary outcome data occurred in 73 patients (principally due to withdrawal of consent) and 1531 (95%) were included in the primary analysis population. The median (IQR) age of participants was 39 (26-55) years, 1251 (79%) were men, median (IQR) Injury Severity Score was 29 (18-43), 36% had penetrating injury, and 33% had systolic blood pressure less than 90 mm Hg at hospital arrival. All-cause 28-day mortality in the intention-to-treat population was 26.1% in the standard care group vs 25.3% in the cryoprecipitate group (odds ratio, 0.96 [95% CI, 0.75-1.23]; P = .74). There was no difference in safety outcomes or incidence of thrombotic events in the standard care vs cryoprecipitate group (12.9% vs 12.7%). Among patients with trauma and bleeding who required activation of a major hemorrhage protocol, the addition of early and empirical high-dose cryoprecipitate to standard care did not improve all cause 28-day mortality. ClinicalTrials.gov Identifier: NCT04704869; ISRCTN Identifier: ISRCTN14998314.

A metabolism-based study of the mechanism of action of Scrophularia ningpoensis Hemsl. on nephrogenic edema.

Nephrogenic edema (NE) is a type of edema with hypoproteinemia and water and sodium retention as a result of renal injury. Traditional Chinese medicine has proved that Scrophularia ningpoensis Hemsl. has an effect on NE, but its mechanism is not clear. In this study, the main components and blood components of S. ningpoensis were identified using ultra-high-performance liquid chromatography-quadrupole-time-of-flight-mass spectrometry (UPLC-Q-TOF-MS). Pathological section and blood biochemical analysis were used to estimate the therapeutic effect of S. ningpoensis on NE. Network pharmacology was used to predict the potential pathways of S. ningpoensis. The metabolomics method was used to study the changes in small-molecule metabolites in the body. The results showed that S. ningpoensis could relieve NE by regulating relative to renal function and body edema, and its mechanism may be related to the regulation of energy metabolism, recovery of renal injury, and reduction in inflammation. The active component harpagoside may be one of the important compounds of S. ningpoensis in the treatment of NE. We confirmed that S. ningpoensis has a therapeutic effect on NE, which provides a solid scientific research basis for the clinical application of S. ningpoensis.

Butylparaben promotes phosphatidylserine exposure and procoagulant activity of human red blood cells via increase of intracellular calcium levels

Parabens are widely used as preservatives, added to products commonly used by humans, and to which individuals are exposed orally or dermally. Once absorbed into the body, parabens move into the bloodstream and travel through the systemic circulation. We investigated the potential impact of parabens on the enhanced generation of thrombin by red blood cells (RBCs), which are the principal cellular components of blood. We tested the effects of methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), butylparaben (BuP), and p-hydroxybenzoic acid on freshly isolated human RBCs. BuP and simultaneous exposure to BuP and PrP significantly increased phosphatidylserine (PS) externalization to the outer membranes of RBCs. PS externalization by BuP was found to be mediated by increasing intracellular Ca2+ levels in RBCs. The morphological changes in BuP-treated RBCs were observed under an electron microscope. The BuP-exposed RBCs showed increased thrombin generation and adhesion to endothelial cells. Additionally, the externalization of PS exposure and thrombin generation in BuP-treated RBCs were more susceptible to high shear stress, which mimics blood turbulence under pathological conditions. Collectively, we observed that BuP induced morphological and functional changes in RBCs, especially under high shear stress, suggesting that BuP may contribute to the thrombotic risk via procoagulant activity in RBCs.

Current state of technical transfusion medicine practice for out-of-hospital blood transfusion in Canada.

Canadian out-of-hospital blood transfusion programmes (OHBTPs) are emerging, to improve outcomes of trauma patients by providing pre-hospital transfusion from the scene of injury, given prolonged transport times. Literature is lacking to guide its implementation. Thus, we sought to gather technical transfusion medicine (TM)-specific practices across Canadian OHBTPs. A survey was sent to TM representatives of Canadian OHBTPs from November 2021 to March 2022. Data regarding transport, packaging, blood components and inventory management were included and reported descriptively. Only practices involving Blood on Board programme components for emergency use were included. OHBTPs focus on helicopter emergency medical service programmes, with some supplying fixed-wing aircraft and ground ambulances. All provide 1-3 coolers with 2 units of O RhD/Kell-negative red blood cells (RBCs) per cooler, with British Columbia trialling coolers with 2 units of pre-thawed group A plasma. Inventory exchanges are scheduled and blood components are returned to TM inventory using visual inspection and internal temperature data logger readings. Coolers are validated to storage durations ranging from 72 to 124 h. All programmes audit to manage wastage, though there is no consensus on appropriate benchmarks. All programmes have a process for documenting units issued, reconciliation after transfusion and for transfusion reaction reporting; however, training programmes vary. Common considerations included storage during extreme temperature environments, O-negative RBC stewardship, recipient notification, traceability, clinical practice guidelines co-reviewed by TM and a common audit framework. OHBTPs have many similarities throughout Canada, where harmonization may assist in further developing standards, leveraging best practice and national coordination.

Unravelling Surface Modification Strategies for Preventing Medical Device-Induced Thrombosis.

The use of biomaterials in implanted medical devices remains hampered by platelet adhesion and blood coagulation. Thrombus formation is a prevalent cause of failure of these blood-contacting devices. Although systemic anticoagulant can be used to support materials and devices with poor blood compatibility, its negative effects such as an increased chance of bleeding, make materials with superior hemocompatibility extremely attractive, especially for long-term applications. This review examines blood-surface interactions, the pathogenesis of clotting on blood-contacting medical devices, popular surface modification techniques, mechanisms of action of anticoagulant coatings, and discusses future directions in biomaterial research for preventing thrombosis. In addition, this paper comprehensively reviews several novel methods that either entirely prevent interaction between material surfaces and blood components or regulate the reaction of the coagulation cascade, thrombocytes, and leukocytes.

Comparing transfusion practice at multiple hospitals using electronically collected and analysed data.

Comparisons of transfusion practice between organisations are time-consuming using manual methods for data collection. We performed a feasibility study to determine whether large-scale transfusion data from three English hospitals could be combined to allow comparisons of transfusion practice. Clinical, laboratory and transfusion data from patients discharged between 1 April 2016 and 31 March 2017 were extracted from Patient Administration Systems (PAS), Laboratory Information Management Systems (LIMS), and electronic transfusion systems at three NHS hospitals, which are academic medical centres based in large cities outside London. A centralised database and business intelligence software were used to compare the data. The dataset contained 748 982 episodes of patient care with 91 410 blood components transfused. The study confirms the results of previous studies finding peaks in the ages of transfusion in the 0-4 years age range, in women of childbearing ages, and in males over 60 years. The number of components transfused per 1000 bed days was used as a standardised comparator. Red cell utilisation was 42.4, 40.4 and 49.5 units/1000 bed days and platelet utilisation 11.69, 7.76, and 11.66 units/1000 bed days. 60.5% (6848/11 310) of Group O D negative red cell units were transfused to non-group O D negative recipients. An analysis of component usage highlighted variations in practice, for example platelet usage for cardiac surgery varied from 2.4% to 7.3% across the three hospitals. This feasibility study demonstrates that large electronic datasets from hospitals can be combined to identify areas for targeted interventions to improve transfusion practice.

Blood Demand Forecasting and Supply Management: An Analytical Assessment of Key Studies Utilizing Novel Computational Techniques

Use of data-driven methodologies in enhancing blood transfusion practices is rising, leveraging big data, machine learning, and optimization techniques to improve demand forecasting and supply chain management. This review used a narrative approach to identify, evaluate, and synthesize key studies that considered novel computational techniques for blood demand forecasting and inventory management through a search of PubMed and Web of Sciences databases for studies published from January 01, 2016, to March 30, 2023. The studies were analyzed for their utilization of various techniques, and their strengths, limitations, and areas for improvement. Seven key studies were identified. The studies focused on different blood components using various computational methods, such as regression, machine learning, hybrid models, and time series models, across different locations and time periods. Key variables used for demand forecasting were largely derived from electronic health record data, including clinical related predictors such as laboratory test results and hospital census by location. Each study offered unique strengths and valuable insights into the use of data-driven methods in blood bank management. Common limitations were unknown generalizability to other healthcare settings or blood components, need for field-specific performance measures, lack of ABO compatibility consideration, and ethical challenges in resource allocation. While data-driven research in blood demand forecasting and management has progressed, limitations persist and further exploration is needed. Understanding these innovative, interdisciplinary methods and their complexities can help refine inventory strategies and address healthcare challenges more effectively, leading to more robust, accurate models to enhance blood management across diverse healthcare scenarios.

P‐TS‐84 | The Incidence of Reported Transfusion Related Acute Lung Injury (TRALI) by Blood Component: A Systematic Review and Meta‐Analysis

P‐TS‐84 | The Incidence of Reported Transfusion Related Acute Lung Injury (TRALI) by Blood Component: A Systematic Review and Meta‐Analysis

P‐PB‐8 | Blood Components Utilization in Pediatric Cardiac Surgeries at a Tertiary Care Freestanding Children's Hospital in India

P‐PB‐8 | Blood Components Utilization in Pediatric Cardiac Surgeries at a Tertiary Care Freestanding Children's Hospital in India

Acute dacryocystitis in aplastic anemia – A case report

Immunosuppression in Aplastic anemia often leads to bacterial sepsis and pneumonias. We report a case of a 33-year female with aplastic anemia, with acute fulminant dacryocystitis. She also had anemic retinopathy in both eyes with subhyaloid hemorrhage in the left eye. The clinical presentation was as with typical acute dacryocystitis with characteristic erythema and edema inferior to medial canthus. However, there was a rapid progression to systemic sepsis. She was treated with blood and blood component transfusion and hematopoietic growth factors in addition to high-dose broad-spectrum lytic antibiotics. The patient responded initially, but clinical course subsequently deteriorated due to systemic involvement. This may have happened due to infected lacrimal sac acting as a persistent focus of infection. This is the first documented case of treatment of acute dacryocystitis in aplastic anemia.