Liquid Plasma Research Articles

Eco-Friendly Synthesis of Silver Nanoparticles Using Pulsed Plasma in Liquid: Effect of Surfactants

Silver (Ag) nanoparticles were successfully prepared by using the in-liquid pulsed plasma technique. This method is based on a low voltage, pulsed spark discharge in a dielectric liquid. We explore the effect of the protecting ligands, specifically Cetyl Trimethylammonium Bromide (CTAB), Polyvinylpyrrolidone (PVP), and Sodium n-Dodecyl Sulphate (SDS), used as surfactant materials to prevent nanoparticle aggregation. The X-Ray Diffraction (XRD) patterns of the samples confirm the face-centered cubic crystalline structure of Ag nanoparticles with the presence of Ag2O skin. Scanning Transmission Electron Microscopy (STEM) reveals that spherically shaped Ag nanoparticles with a diameter of 2.2 ± 0.8 nm were synthesised in aqueous solution with PVP surfactant. Similarly, silver nanoparticles with a peak diameter of 1.9 ± 0.4 nm were obtained with SDS surfactant. A broad size distribution was found in the case of CTAB surfactant.

Understanding the chemical kinetics for plasma in liquid: Reaction mechanism of ethanol reforming in microwave discharge

Toward understanding the chemical nature of fuel reforming in liquid phase discharge, a novel kinetic model with being governed by both mass and energy equations was developed for the first time. The model reliability was verified by experimental results for ethanol reforming with water by microwave discharge plasma in liquid (MDPL). The reaction kinetics of ethanol in MDPL were revealed quantitatively. It illustrated that the key reactive species in the MDPL were H, OH, HCO, C and C x H y radicals, which induced the productions of H 2 , CO and hydrocarbons (CH 4 and C 2 H 2 ). The rate determining steps for ethanol conversion were identified as dehydrogenizing ethanol to C 2 H 5 O firstly, and then splitting to CH 2 O and CH 3 radicals. Those two species of CH 2 O and CH 3 governed the formation of CO and hydrocarbons respectively. In addition, the kinetic control mechanism for ethanol reforming in MDPL determined that ethanol was converted by mixed routes of pyrolysis and steam reforming at low initial ethanol molar concentration in liquid ( C e t h L <50%), and it was converted via only pyrolysis route at C e t h L >50%. Water in the liquid supplied OH radical promoting the conversion of C x H y to CO, thereby it regulated the reaction pathway transition between pyrolysis and steam reforming. The energy transfer pathway for discharge power to chemical energy, very important but never discussed for plasma reforming in liquid, was also simulated. It revealed that a very competitive energy efficiency of ∼85% for ethanol reforming was achieved in the MDPL. • Ethanol reforming was mainly induced by radicals of H, OH, HCO, C and C x H y . • Three reaction pathways for ethanol conversion in plasma were predicted. • Ethanol pyrolysis is the major reaction route for ethanol conversion. • The rate determining step was revealed as ethanol dehydrogenated to C 2 H 5 O. • An excellent energy efficiency of 85% was reached.

Dependence of Discharge Conditions on Characteristics of Nano-Carbon Material Synthesized by Plasma in Liquid

Dependence of Discharge Conditions on Characteristics of Nano-Carbon Material Synthesized by Plasma in Liquid

Synthesis of graphene via in-liquid discharge plasma: A green, novel strategy and new insight

The synthesis of reduced graphene oxide (rGO) in an efficient manner has attracted considerable attention because of extensive applications in electronics, composite materials, and energy-storage devices. Here we propose a novel strategy for reducing graphene oxide (GO) by microwave discharge plasma in liquid (MDPL). This method is of fast reduction, high reactivity, and low temperature, which is suitable for efficient graphene preparation. The XPS results show that MDPL reduces the initial oxygen content of GO by more than 60%. Electrical characterization of rGO shows an enhanced conductivity of 70 S/m. The atomic hydrogen and energetic electrons in MDPL can effectively facilitate the deoxygenation and the recovery of π-conjugation of GO. As a supercapacitor electrode, plasma-treated rGO can deliver a gravimetric capacitance of 164.9 F/g at a scan rate of 5 mV/s. To summarize, our study paves the way towards the mild, eco-friendly, and efficient production of graphene.

Hydrogenated Amorphous Titania with Engineered Surface Oxygen Vacancy for Efficient Formaldehyde and Dye Removals under Visible-Light Irradiation.

Hydrogenated crystalized TiO2−x with oxygen vacant (OV) doping has attracted considerable attraction, owing to its impressive photoactivity. However, amorphous TiO2, as a common allotrope of titania, is ignored as a hydrogenated templet. In this work, hydrogenated amorphous TiO2−x (HAm-TiO2−x) with engineered surface OV and high surface area (176.7 cm2 g−1) was first prepared using a unique liquid plasma hydrogenation strategy. In HAm-TiO2−x, we found that OV was energetically retained in the subsurface region; in particular, the subsurface OV-induced energy level preferred to remain under the conduction band (0.5 eV) to form a conduction band tail and deep trap states, resulting in a narrow bandgap (2.36 eV). With the benefits of abundant light absorption and efficient photocarrier transportation, HAm-TiO2−x coated glass has demonstrated superior visible-light-driven self-cleaning performances. To investigate its formaldehyde photodegradation under harsh indoor conditions, HAm-TiO2−x was used to decompose low-concentration formaldehyde (~0.6 ppm) with weak-visible light (λ = 600 nm, power density = 0.136 mW/cm2). Thus, HAm-TiO2−x achieved high quantum efficiency of 3 × 10−6 molecules/photon and photoactivity of 92.6%. The adsorption capabilities of O2 (−1.42 eV) and HCHO (−1.58 eV) in HAm-TiO2−x are both largely promoted in the presence of subsurface OV. The surface reaction pathway and formaldehyde decomposition mechanism over HAm-TiO2−x were finally clarified. This work opened a promising way to fabricate hydrogenated amorphous photocatalysts, which could contribute to visible-light-driven photocatalytic environmental applications.

Hemostatic Activity of Canine Never-Frozen Liquid Plasma Collected for Transfusion.

This study measured the changes of hemostatic activity in liquid plasma (LP) over 7 days of storage. Five canine plasma units, divided into two aliquots were evaluated: one stored refrigerated at 2–6°C as never-frozen LP and one frozen at −18°C as fresh frozen plasma (FFP). Clotting times, coagulation activities of factor (F) V, VIII, X, XI, antithrombin (AT), and von Willebrand (vWF), fibrinogen and D-dimers (DD) content were assessed before storage (baseline value), and after 12, 24, 48 h and 7 days (D7) in LP stored refrigerated, and on day 7 in FFP. At baseline median values of all factor activity were greater than 80%, and for clotting times, AT, fibrinogen and DD content, were within the canine reference range. Some hemostatic parameters changed significantly over 7 days and at the end of storage in LP. However, median activities of FV, FVIII, FX and FXI, coagulation time, AT, fibrinogen and DD content remained within reference ranges at all time points. The only exception was for vWF which median activity was lower than reference range for all storage time points. Activity of FVIII was significant lower in LP at D7 when compared to activity in FFP, with values of 62 vs. 118%, respectively. DD content showed a median value higher than reference range in FFP at D7. Despite some statistically significant changes at the end of 7-day storage period, never-frozen LP maintained median factor activities >80% for most factors. The clinical impact of the drop over time of vWF activity is unknown.

Frequency-dependent complex viscosity obtained for a liquid two-dimensional dusty plasma experiment.

Strongly coupled plasmas in a liquid phase can be characterized by a complex viscosity η(ω), which is a function of frequency. Data from a single experiment with dusty plasma were analyzed to compare η(ω) obtained by two fundamentally distinct methods. In a nonequilibrium method, a pair of counterpropagating laser beams, separated by a gap, applied a sinusoidal shear to a two-dimensional liquid, and η(ω) was determined using the constitutive relation. In an equilibrium method, there was no externally applied shear, so η(ω) could be calculated with a generalized Green-Kubo relation. The results for these two methods are compared for the real and imaginary parts of η(ω). For both parts, it is confirmed that the two methods yield results that agree qualitatively in their trends with frequency, with the real part diminishing with ω and the imaginary part increasing with ω, as expected for viscoelastic liquids. Quantitatively, the values of η(ω) obtained by the two methods differ slightly. For the experiment that we analyze, values for the real and imaginary parts of η(ω) are substantially greater than those reported in an earlier experiment, which we attribute to shear thinning effects in the earlier experiment. The experiment we analyze was designed to minimize shear thinning, unlike the earlier experiment.

Advances in hemorrhage control resuscitation.

Despite significant advances in trauma management over the last twenty years, uncontrolled hemorrhage remains the leading cause of preventable death in trauma. We review recent changes affecting hemorrhage control resuscitation. Early blood product usage has become well established as a standard of care in trauma hemorrhage control. To enable this, low titer group A liquid plasma and group O whole blood are increasingly utilized. Single donor apheresis platelets have now replaced pooled donor platelets in the USA and are often pathogen reduced, which has implications for trauma resuscitation. Further work is examining timing and dosing of tranexamic acid and the debate in factor concentrate usage in trauma induced coagulopathy continues to evolve. The 'Stop the bleed' campaign has highlighted how important the use of hemostatic dressings are in hemorrhage control, as too is the expanded use of endovascular aortic occlusion. We highlight the ongoing research into desmopressin use and the undetermined significance of ionized calcium levels in trauma. Finally, we discuss our own hospital experience with coagulation testing and the paucity of evidence of improved outcomes with viscoelastic testing. Improving trauma coagulopathy diagnostics and hemorrhage control are vital if we are to decrease the mortality associated with trauma.

A modular and reconfigurable open-channel gated device for the electrokinetic extraction of cell-free DNA assays

The high-efficiency separation and extraction of short fragments of cell-free DNA (cfDNA) remain challenging due to their low abundance and short lengths. This study presents a method for separating short cfDNA fragments, with lengths ranging from about 100 to 200 base pairs, from liquid human plasma samples into separable and extractable bands as solid agarose gel slabs. To achieve this, a novel millimeter-scale fluidic device is used for sample handling, transient isotachophoresis, and extraction. The device features open-to-atmosphere liquid chambers that define and manually actuated (i.e., movable) agarose-made gate valve structures. The agarose gates then define discrete zones for buffers, sample injection, DNA pre-concentration via isotachophoresis, size-based gel separation, and DNA-band extraction. As a demonstration of its efficacy, the device is applied to the enrichment and purification of M. tuberculosis genomic DNA fragments spiked in human plasma samples. This purified cfDNA is analyzed using the quantitative polymerase chain reaction (qPCR) of the IS6110 repetitive sequence in the M. tuberculosis genome. The data from this study demonstrates that high sensitivity can be achieved in cfDNA detection, as shown by the comparison with a typical solid-phase extraction method and buffer spiked with cfDNA. Evidence is presented that suggests plasma peptides generated by treatment of the sample with proteinase K acts as endogenous spacer molecules, which improve the resolution and purification of DNA relative to the marker dye and other contaminants that decrease the signal level in qPCR.

Descriptive Analysis of Blood Product Administration in Air Medical Trauma Patients

<h3>Objectives</h3> Early administration of blood products is associated with improved survival from traumatic injury. Helicopters have the ability to initiate infusion of blood products in the out-of-hospital environment, but the experience of air medical blood product administration is not well characterized. The objective of this analysis is to describe the experience of a large air medical service with out-of-hospital administration of blood products. <h3>Methods</h3> We performed a descriptive study with a secondary cohort analysis. This study was conducted over a two-year period (2019-2020) in a large air medical company. A total of 139 bases had access to blood products at some interval during the study period. Subjects for this analysis included all trauma patients receiving one or more of the following blood products in the out-of-hospital setting: packed red blood cells (PRBCs), whole blood (WB), fresh-frozen or liquid plasma (plasma), platelets. Data collected for each subject included: demographics, scene/interfacility, blood products administered, and vital signs before and after blood product administration. Data were presented descriptively. In addition, initial and final vital signs were compared to assess the effect of blood product administration. Finally, we compared scene calls to interfacility transports with regard to demographic data, blood product administration, and vital signs. Descriptive data were reported using mean or frequency with 95% confidence intervals. T-testing and chi-square analysis were used for all comparisons, with statistical significance set for p<0.05. <h3>Results</h3> Over the two-year study period, a total of 1587 trauma patients [1504 adult, 83 pediatric] receiving out-of-hospital blood products were identified for analysis. These included 1010 scene calls and 577 interfacility transports. A total of 1152 patients (72.6%) were male. The distribution of blood products included: 647 patients (40.8%) received PRBCs alone; 65 patients (4.1%) received WB alone; 312 patients (19.7%) received plasma alone; 544 patients (34.3%) received PRBCs/plasma; 2 patients (0.1%) received WB/PRBCs; 3 patients (0.2%) received WB/plasma; 6 patients (0.4%) received platelets alone; 5 patients (0.3%) received platelets/PRBCs; 3 patients (0.2%) received PRBCs/plasma/platelets. Interfacility transport patients were more likely than scene call patients to receive PRBCs. An increase in blood pressure (+4 mmHg) and decrease in heart rate (-8 beats/min) were observed following blood product administration. A greater improvement in blood pressure and decrease in heart rate were observed for scene call versus interfacility patients following blood administration. <h3>Conclusions</h3> Blood product administration appears to be an important component of air medical transport, with substantial number of trauma patients receiving some combination of PRBCs, WB, plasma, and platelets. Improvements in vital signs were observed, particularly in scene call patients. These data give valuable insight into the out-of-hospital administration of blood products by air medical providers.

Nonthermal Plasma in Contact with Liquids

"The current work shows the generation methods of atmospheric pressure plasma in liquids or on liquids. The optical diagnosis proves the nonthermal character of generated plasmas. They were tested for dyes degradation, nanostructures synthesis and for obtaining of plasma activated water. The activated water preserves its new characteristics for at least three weeks and is a promising agent for bacterial inhibition. Keywords: in/on-liquid plasma, dye degradation, nanoparticles synthesis, plasma activated water, bacterial inhibition. "

Exploring liquid plasma jets using short laser pulses

Method probes the optical properties of laser-induced liquid plasmas using extremely short laser pulses.

Enhanced antibacterial activity of selenium nanoparticles prepared by cold plasma in liquid

In this study, selenium Nanoparticles were synthesized using selenium nitrate in a physical way (using cold plasma produced under normal atmospheric pressure) operating on alternating current AC with a voltage of (13) kV. Its frequency is (23) kHz, and the speed of the Argon gas flow is (3) L/min with an exposure time of 3 min. Selenium Nanoparticles were prepared in four different concentrations (0.2, 0.4, 0.6, and 0.8 ) mM, then the selenium Nanoparticles were characterized by UV-VIS spectroscopy, where (absorption, transmittance, absorption coefficient, energy gap) were measured for all concentrations where it was observed The absorbance increased with the increase in the concentration of the material, while the permeability decreased. The energy gap was at the lowest concentration, 1.74 electron volts. With the increase in concentration, it was noticed that the energy gap decreases, and this is due to the transformation of the material to the nanoscale. Nanoparticle characteristics have been investigated (XRD, AFM, FESEM, and UV-Vis). The biological activity of selenium Nanoparticles was tested by the method of diffusion in the medium towards Gram-positive bacteria Klebsiella Pneumoniae and Gram-negative Staphylococcus. aureus, where the highest inhibition rate was recorded for Gram-negative bacteria, reaching (31, 30, 20, 22) mm, respectively, in the case of bacteria. The positive amount reached (29, 24, 24 20) mm, respectively, where it was noticed that the concentration of the substance increased, the rate of the inhibition diameter increased.

Photocatalytic hydrogen production using liquid phase plasma from ammonia water over metal ion-doped TiO2 photocatalysts

Ammonia can be applied as a hydrogen carrier and used directly as a hydrogen production supply. In this paper, a technique for mass-producing hydrogen from ammonia water is proposed by applying a liquid phase plasma (LPP) discharge technique and a photocatalyst. In this reaction, N- and Fe ion codoped TiO2 (N/Fe/TiO2) photocatalysts were prepared and applied as a visible light-sensitive photocatalyst. N/Fe/TiO2 (NFT) had a similar crystal shape and size to anatase TiO2, but the surface was doped with metal ions. The bandgap of the NFT photocatalyst obtained from the spectrum measured by photoluminescence spectroscopy was approximately 2.4 eV. Nitrogen and Fe ions played a role in narrowing the gap between the conduction band (CB) and valence band (VB) of TiO2, effectively reducing the bandgap. In the decomposition reaction of ammonia water by LPP irradiation, the NFT photocatalyst showed the highest hydrogen evolution rate. The amount of hydrogen produced from ammonia water by LPP irradiation on the NFT photocatalyst was approximately 133 L/h. The hydrogen production rate obtained from ammonia water by the photocatalyst and LPP irradiation was significantly higher than that obtained by the ammonia electrolysis process.

Diagnostic Accuracy of Dried Plasma Spot Specimens for HIV-1 Viral Load Testing: A Systematic Review and Meta-analysis.

Dried plasma spot specimens may be a viable alternative to traditional liquid plasma in field settings, but the diagnostic accuracy is not well understood. Standard databases (PubMed and Medline), conferences, and gray literature were searched until January 2019. The quality of evidence was evaluated using the Standards for Reporting Studies of Diagnostic Accuracy and Quality Assessment of Diagnostic Accuracy Studies-2 criteria. We used univariate and bivariate random effects models to determine misclassification, sensitivity, and specificity across multiple thresholds, overall and for each viral load technology, and to account for between-study variation. We identified 23 studies for inclusion in the systematic review that compared the diagnostic accuracy of dried plasma spots with that of plasma. Primary data from 16 of the 23 studies were shared and included in the meta-analysis, representing 18 countries, totaling 1847 paired dried plasma spot:plasma data points. The mean bias of dried plasma spot specimens compared with that of plasma was 0.28 log10 copies/mL, whereas the difference in median viral load was 2.25 log10 copies/mL. More dried plasma spot values were undetectable compared with plasma values (43.6% vs. 29.8%). Analyzing all technologies together, the sensitivity and specificity of dried plasma spot specimens were >92% across all treatment failure thresholds compared and total misclassification <5.4% across all treatment failure thresholds compared. Some technologies had lower sensitivity or specificity; however, the results were typically consistent across treatment failure thresholds. Overall, dried plasma spot specimens performed relatively well compared with plasma with sensitivity and specificity values greater than 90% and misclassification rates less than 10% across all treatment failure thresholds reviewed.

A comparison between liquid group A plasma and thawed group A plasma for massive transfusion activation in trauma patients.

The use of group A thawed 24-h plasma when resuscitating haemorrhagic shock patients has become more common; however, limited data exist on the clinical use of liquid plasma (LP). Our aim is to determine whether LP is of clinical benefit to patients requiring massive transfusion. The objective of this retrospective study was to detect any difference in 24-h survival between patients receiving liquid or thawed plasma (TP) during their massive transfusion activation. Other objectives were to report any difference in hospital length of stay (LOS), intensive care unit (ICU) LOS and in-hospital survival. Data collected included gender, age, mechanism of injury, Injury Severity Score, Revised Trauma Score and Trauma Injury Severity Score. A total of 178 patients received 1283 units of LP, median 4 and range (1-56), whereas 270 patients received 2031 units of TP, median 5 and range (1-87). The two study groups were comparable in terms of gender, age, mechanism of injury, whole blood, red blood cells, platelets and cryoprecipitate transfused. The use of LP during the massive transfusion activation in traumatically injured patients was not associated with increased 24-h survival compared to when using TP, p= 0.553. Our study did not show a difference in 24-h or 30-day survival between the use of LP compared to TP in trauma patients. LP should be considered an alternative to TP in trauma patients requiring immediate plasma resuscitation.

Hydrogenated Amorphous TiO2-x and Its High Visible Light Photoactivity.

Hydrogenated crystalline TiO2 with oxygen vacancy (OV) defect has been broadly investigated in recent years. Different from crystalline TiO2, hydrogenated amorphous TiO2−x for advanced photocatalytic applications is scarcely reported. In this work, we prepared hydrogenated amorphous TiO2−x (HA-TiO2−x) using a unique liquid plasma hydrogenation strategy, and demonstrated its highly visible-light photoactivity. Density functional theory combined with comprehensive analyses was to gain fundamental understanding of the correlation among the OV concentration, electronic band structure, photon capturing, reactive oxygen species (ROS) generation, and photocatalytic activity. One important finding was that the narrower the bandgap HA-TiO2−x possessed, the higher photocatalytic efficiency it exhibited. Given the narrow bandgap and extraordinary visible-light absorption, HA-TiO2−x showed excellent visible-light photodegradation in rhodamine B (98.7%), methylene blue (99.85%), and theophylline (99.87) within two hours, as well as long-term stability. The total organic carbon (TOC) removal rates of rhodamine B, methylene blue, and theophylline were measured to 55%, 61.8%, and 50.7%, respectively, which indicated that HA-TiO2−x exhibited high wastewater purification performance. This study provided a direct and effective hydrogenation method to produce reduced amorphous TiO2−x which has great potential in practical environmental remediation.

Platelet-Rich Fibrin Decreases the Inflammatory Response of Mesenchymal Cells.

Chronic inflammation is a pathological process where cells of the mesenchymal lineage become a major source of inflammatory mediators. Platelet-rich fibrin (PRF) has been shown to possess potent anti-inflammatory activity in macrophages, but its impact on mesenchymal cells has not been investigated. The aim of this study was, therefore, to expose mesenchymal cells to inflammatory cytokines together with lysates generated from liquid platelet-poor plasma (PPP), the cell-rich buffy coat layer (BC; concentrated-PRF or C-PRF), and the remaining red clot layer (RC), following centrifugation of blood. Heating PPP generates an albumin gel (Alb-gel) that when mixed back with C-PRF produces Alb-PRF. Membranes prepared from solid PRF were also subjected to lysis. We report here that lysates of PPP, BC, and PRF decreased the cytokine-induced expression of interleukin 6 (IL6) and nitric oxide synthase (iNOS) in the bone marrow-derived ST2 cells. Consistently, PPP, BC, and PRF greatly decreased the phosphorylation and nuclear translocation of p65 in ST2 cells. The inflammatory response caused by Pam3CSK4 was reduced accordingly. Moreover, PPP, BC, and PRF reduced the enhanced expression of inflammatory mediators IL6 and iNOS in 3T3-L1 pre-adipocyte mesenchymal cells, and iNOS and CCL5 in murine calvarial cells. Surprisingly, PRF lysates were not effective in reducing the inflammatory response of human gingival fibroblasts and HSC2 epithelial cells. The data from the present study suggest that both liquid PRF and solid PRF exert potent anti-inflammatory activity in murine mesenchymal cells.

Perancangan Teknologi Sederhana Untuk Membangkitkan Microwave Plasma Dalam Cairan

Plasma technology has interested, especially plasma in liquid which can be applied in the process of gas productions, water treatment, and nanomaterial productions. The purpose of this study is to make a simple technology 2.45 GHz microwave plasma and generate in the variation of liquids such as distilled water, seawater, and X-Ray liquid waste by utilizing a microwave oven, as well as to observe the effect of vacuum pressure variations. A microwave oven was modified by integrating a waveguide and a plasma reactor for plasma observation. The results, plasma was generated in distilled water at a vacuum pressure of about 7 kPa, X-Ray liquid waste at a vacuum pressure of about 13 kPa, and seawater at a vacuum pressure of about 34 kPa.

The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient.

The recognition and management of life-threatening hemorrhage in the polytrauma patient poses several challenges to prehospital rescue personnel and hospital providers. First, identification of acute blood loss and the magnitude of lost volume after torso injury may not be readily apparent in the field. Because of the expression of highly effective physiological mechanisms that compensate for a sudden decrease in circulatory volume, a polytrauma patient with a significant blood loss may appear normal during examination by first responders. Consequently, for every polytrauma victim with a significant mechanism of injury we assume substantial blood loss has occurred and life-threatening hemorrhage is progressing until we can prove the contrary. Second, a decision to begin damage control resuscitation (DCR), a costly, highly complex, and potentially dangerous intervention must often be reached with little time and without sufficient clinical information about the intended recipient. Whether to begin DCR in the prehospital phase remains controversial. Furthermore, DCR executed imperfectly has the potential to worsen serious derangements including acidosis, coagulopathy, and profound homeostatic imbalances that DCR is designed to correct. Additionally, transfusion of large amounts of homologous blood during DCR potentially disrupts immune and inflammatory systems, which may induce severe systemic autoinflammatory disease in the aftermath of DCR. Third, controversy remains over the composition of components that are transfused during DCR. For practical reasons, unmatched liquid plasma or freeze-dried plasma is transfused now more commonly than ABO-matched fresh frozen plasma. Low-titer type O whole blood may prove safer than red cell components, although maintaining an inventory of whole blood for possible massive transfusion during DCR creates significant challenges for blood banks. Lastly, as the primary principle of management of life-threatening hemorrhage is surgical or angiographic control of bleeding, DCR must not eclipse these definitive interventions.