Blood Of Surgical Patients Research Articles

Neutrophil extracellular traps as markers of infectious and aseptic inflammation

One of the important problems of medicine is the search for new reliable markers of inflammation that would allow us to determine the type of inflammatory process. The aim of the study was to identify specific markers of infectious and aseptic inflammation based on the analysis of morphological variants of neutrophil extracellular traps (NETs). The study included 26 patients with various nosological forms of inflammation in the abdominal cavity (12 with acute appendicitis, 8 with acute cholecystitis, 6 with a diagnosis of pancreatitis/ pancreonecrosis) after surgery. The study also included 20 patients with post-COVID and a group of 10 volunteers no clinical manifestations of the disease, but at the same time had contacts with flu patients. Neutrophils were isolated using gradient centrifugation. Fluorescence microscopies with the dye SYBR Green (JSC “Evrogen”, Russia) were used for NET visualization and counting. NETs in the morphological form of neutrophils web structure were found in the blood of surgical patients with acute appendicitis who had a favorable course of the postoperative period. In a group of volunteers who were exposed to influenza but did not have symptoms of an infectious disease, we also found neutrophils web structure. In all patients with abdominal inflammation complicated by abdominal abscess, in addition to neutrophil web structure, abnormal forms of NETs were recorded, in particular, NETs in the form of single filaments. In the post-COVID patients an absolute absence of neutrophilis web structure was revealed. In all post-COVID patients, NETs are found only in the form of single filaments. The results of subsequent experiments showed that collagen peptides are inducers of the formation of NETs in the form of single filaments. The detection of neutrophils web structure is a sign of an infectious inflammatory process. NETs in the morphological form of single filaments are markers of aseptic inflammation, as well as a sign of endothelial damage.

Diagnosis of Bacterial Translocation by the Detection of Microbial DNA in the Blood of Surgical Patients

Diagnosis of Bacterial Translocation by the Detection of Microbial DNA in the Blood of Surgical Patients

The detection of microbial DNA in the blood in surgical patients

The detection of microbial DNA in the blood in surgical patients

The detection of microbial DNA in the blood: a sensitive method for diagnosing bacteremia and/or bacterial translocation in surgical patients.

The purpose was to determine the sensitivity of detecting microbial DNA in the blood of surgical patients as a measure for diagnosing systemic infection and/or translocation from the gut. Microbial infections and translocation of intestinal bacteria are thought to contribute to multiple system organ failure, but bacterial cultures are often negative in patients with this complication. DNA was extracted from the blood of 40 surgical patients and 20 healthy controls. Polymerase chain reaction (PCR) techniques were used to amplify genes from Escherichia coli, Bacteroides fragilis, and a region of 16S ribosomal RNA found in many gram-positive and -negative bacteria. Bacterial DNA genes were not detected in healthy volunteers but were found in all patients with positive blood cultures. All eight transplant patients receiving OKT3 therapy had microbial DNA in their blood, possibly indicating translocation from the gut. Sixty-four percent of critically ill patients had microbial DNA detected in their blood, but only 3 (14%) had positive blood cultures. The PCR method is more sensitive than blood cultures for detecting bacterial components in the blood of critically ill surgical patients and may detect microbial translocation from the intestine.

Autologous blood transfusion.

Autologous blood transfusion is an endorsed blood conservation strategy that has become widely practiced in elective surgical procedures. We review ten years' experience in this arena, along with emerging strategies designed to continue to minimize allogeneic blood exposure but reduce the costs associated with autologous blood procurement. We conclude that point-of-care autologous blood procurement (acute normovolemic hemodilution and intraoperative autologous blood salvage) can replace the predonation of autologous blood in surgical patients when transfusion medicine specialists, anesthesiologists, and surgeons develop a prospective, comprehensive approach to blood conservation.

Use of unrefrigerated fresh whole blood in massive transfusion.

To establish the efficacy of transfusion of fresh unrefrigerated whole blood in surgical patients with ongoing massive bleeding despite adequate blood-component replacement therapy and adequate surgical haemostasis. A retrospective review of patients who received fresh unrefrigerated whole-blood transfusions, noting blood usage and outcome. A tertiary care teaching hospital with a major cardiac surgical and trauma service. All patients (n=11) receiving fresh unrefrigerated whole-blood transfusions from March 1992 to February 1995. Mean blood usage in the 24 hours before the decision to transfuse fresh unrefrigerated whole blood was 16.5 units of packed cells (range, 6-27), 17.1 units of platelets (8-32), 14.5 units of fresh frozen plasma (6-26) and 13.5 units of cryoprecipitate (4-36). After the transfusion of fresh whole blood there was an immediate and substantial reduction in the rate and volume of blood loss in all patients. This was sustained in seven patients, who had a successful outcome; the other four patients died within 24 hours from recurrent uncontrollable haemorrhage. The reduction in blood usage in the 24 hours after the transfusion of fresh whole blood was statistically significant in the surviving patients but not in the patients who died. None of the surviving patients showed evidence of viral seroconversion six months after the transfusion. Our study provides preliminary evidence that there is a role for transfusion of fresh unrefrigerated whole blood in surgical patients with unresponsive life-threatening haemorrhage.

Head Space Mass Spectrometric Analysis for Volatiles in Biological Specimens

A simple and rapid heed space mess spectrometric screening technique for volatlles in blood and post-mortem tissues Is described. Mass spectral data on specimens trom acute toxicities due to fluorocarbons (Freens), methane, diethylether, and toluene are presented. The presence of the volatile anesthetic agents, nitrous oxide, halothane (Fluothane) and enflurane (Ethrane), in the blood of surgical patients is demonstrated. Xylene, toluene, CCl4, CHCl3, acetonitrlle, and methylethylketone In blood-enriched specimens also exhibit characteristic mass spectra. The detection limit for this technique Is approximately 1/~g / ml.