Ml Of Blood Withdrawn Research Articles

What's New in Shock, February 2021?

What's New in Shock, February 2021?

Scientific approach for ozone absorption in blood during systemic indirect endovenous ozonetherapy

Introduction.
 Reading reference ozone books from Dra. Menendez, Dra. Viebhan, Dra. Borrelli and Dr. Bocci, proper timing for mixing ozone in blood during autohemotherapy is not calculated in a scientific way, having only an estimation of it based on changes in the blood color, more related to oxygen absorption than on ozone itself.
 
 Material and methods.
 We decided to reproduce a reduced model of great autohemotherapy or recently renamed as systemic indirect endovenous ozonotherapy (SIEVO) by the World Federation of Ozone Therapy – WFOT, using syringes to simplify the experiment. Our model consisted of a 20 mL syringe filled with 10 mL of blood withdrawn from healthy volunteers and mixed it gently but in controlled way with 10 mL medical ozone at different concentrations; after 5 and 8 seconds, the remaining gas was analyzed by an spectrophotometer based ozone detector to check the amount of ozone. Data were analyzed using a linear regression model. 
 
 Results.
 Results show that even for 60 mcgr/mL ozone concentration, 8 seconds is enough to let all ozone absorbed in blood.
 
 Discussion and Conclusions.
 The experiment shows how quick ozone reacts with blood and claims for a trial with real SIEVO devices to achieve a real timing.

A Model of Rat Embolic Cerebral Infarction with a Quantifiable, Autologous Arterial Blood Clot

We developed a novel model of a rat embolic cerebral infarction with a quantifiable autologous arterial blood clot. The left femoral artery had 0.15 ml of blood withdrawn and mixed with 10 units of thrombin in 50 μl saline. After 30 min, the clot was suctioned into a 4-French polyvinyl chloride tube. A 24-gage catheter was inserted up through the internal carotid artery via the external carotid artery stump. The 1-cm clot, at a volume of 7.2 mm3, was pushed and inserted into the internal carotid artery via the catheter. After withdrawing the catheter, the ICA blood flow recovered. We checked neurological status after 24 h (neurological free was 15, and worst was 1) and measured the infarction volume by the TTC method. Twelve rats were examined, and five sham-operated rats were included. Two rats were not able to achieve an 80% reduction in CBF. One rat died due to cerebral infarction. The success rate in producing infarction was 83%. The total infarction volume was 368.5 mm3±61.2 se. Median neurological score was 6. Hemorrhagic transformation was not detected. Sham-operated rats revealed no infarction and no neurological deficit. The volume of infarction correlated significantly with the neurological score. We conclude that this embolic stroke model is useful in producing a human, severe cardioembolic cerebral infarction.

Using Time-Frequency Analysis of the Photoplethysmographic Waveform to Detect the Withdrawal of 900 mL of Blood

We designed this study to determine if 900 mL of blood withdrawal during spontaneous breathing in healthy volunteers could be detected by examining the time-varying spectral amplitude of the photoplethysmographic (PPG) waveform in the heart rate frequency band and/or in the breathing rate frequency band before significant changes occurred in heart rate or arterial blood pressure. We also identified the best PPG probe site for early detection of blood volume loss by testing ear, finger, and forehead sites. Eight subjects had 900 mL of blood withdrawn followed by reinfusion of 900 mL of blood. Physiological monitoring included PPG waveforms from ear, finger, and forehead probe sites, standard electrocardiogram, and standard blood pressure cuff measurements. The time-varying amplitude sequences in the heart rate frequency band and breathing rate frequency band present in the PPG waveform were extracted from high-resolution time-frequency spectra. These amplitudes were used as a parameter for blood loss detection. Heart rate and arterial blood pressure did not significantly change during the protocol. Using time-frequency analysis of the PPG waveform from ear, finger, and forehead probe sites, the amplitude signal extracted at the frequency corresponding to the heart rate significantly decreased when 900 mL of blood was withdrawn, relative to baseline (all P < 0.05); for the ear, the corresponding signal decreased when only 300 mL of blood was withdrawn. The mean percent decrease in the amplitude of the heart rate component at 900 mL blood loss relative to baseline was 45.2% (38.2%), 42.0% (29.2%), and 42.3% (30.5%) for ear, finger, and forehead probe sites, respectively, with the lower 95% confidence limit shown in parentheses. After 900 mL blood reinfusion, the amplitude signal at the heart rate frequency showed a recovery towards baseline. There was a clear separation of amplitude values at the heart rate frequency between baseline and 900 mL blood withdrawal. Specificity and sensitivity were both found to be 87.5% with 95% confidence intervals (47.4%, 99.7%) for ear PPG signals for a chosen threshold value that was optimized to separate the 2 clusters of amplitude values (baseline and blood loss) at the heart rate frequency. Meanwhile, no significant changes in the spectral amplitude in the frequency band corresponding to respiration were found. A time-frequency spectral method detected blood loss in spontaneously breathing subjects before the onset of significant changes in heart rate or blood pressure. Spectral amplitudes at the heart rate frequency band were found to significantly decrease during blood loss in spontaneously breathing subjects, whereas those at the breathing rate frequency band did not significantly change. This technique may serve as a valuable tool in intraoperative and trauma settings to detect and monitor hemorrhage.

Thyroid hormones profile in students of Makerere College of Health Sciences in Kampala Uganda

Serum concentrations of thyroxine (T4), triiodothyronine (T3) and Thyroid Stimulating Hormone (TSH) are used to assess thyroid function. It is recommended that each laboratory or hospital should establish its own reference values of T4, T3 and TSH for their clients because these hormones vary with ethnicity, geographical and climatic conditions of a population. There is no documented study which has been done to determine the Thyroid hormones profile in Ugandan general population. This study is one of the first attempts to determine Thyroid hormones profile in healthy Ugandans. The main objective of this study was to determine the thyroid hormones profile of students of the Makerere College of Health Sciences in Kampala, Uganda. A cross sectional descriptive study was done involving 72 students, with the mean age of 24.17 +/- 4.48 years. Subjects who volunteered to participate in the study were interviewed; their height and body weight measured, 5 ml of blood withdrawn, and sera harvested. FT4 and T3 Radioimmuno Assay (RIA) were done and TSH was assayed using Immunoradiometric Assay (IRMA) technique. The mean serum concentration of FT4 was 17.016 +/- 3.847 mol/L. For T3, mean serum concentration was 1.43 +/- 0.825 nmol/L, and mean serum TSH level was 2.412 +/- 2.284 microIU/ml. Variations of serum concentrations of FT4, T3 and TSH with sex, age, or region of origin were not statistically significant. Serum concentration of TSH increased with increased body mass index (BMI). It was 2.073 +/- 1.907 microIU/ml for subjects with BMI of < or = 24.9 Kg/m2, 3.588 +/- 1.495 microIU/ml for subjects with BMI of 25 - 29.9 kg/m2 and 4.450 +/- 0.593 microIU/ml for subjects with BMI > or = 30 kg/m2 (P=0.009). However, BMI had no effect on serum concentrations of FT4 and T3. Serum concentrations of T4, T3 and TSH obtained from this study all differ with the values which are currently used as reference ranges in the country. We recommend a similar study involving a population representative of Ugandans to be conducted so as to establish normal reference values of T4, T3 and TSH for Ugandans. We also recommend BMI of patients to be taken into consideration during interpretation of serum TSH concentrations results.

Will Nephrologists Use a Wearable Artificial Kidney?

Willem Johan Kolff, despite shortages of materials under the oppressive World War II German occupation of the Netherlands in 1942, designed and fabricated the world's first practical artificial kidney. In his 1947 recounting of initial trials of the artificial kidney, aptly titled “New Ways of Treating Uraemia,” Kolff restricted treatments to those who had acute kidney injury, believing that “chronic nephritis is no indication for treatment with the artificial kidney, although an acute exacerbation of a chronic uraemia might be an indication in some cases” ( 1). Tentatively limiting dialysis to 50 ml of blood withdrawn from a vein, Kolff gradually increased the volume of blood aliquots to 100 ml in intermittent treatments that lasted as long as 17 h at estimated urea clearances of 140 ml/min and removed as much as 268 g of urea during a single dialysis session. Lacking pressure control of circulating blood within the dialyzer, fluid was extracted by raising dialysate osmolality with glucose added to the salt and bicarbonate mixture. Sixteen patients underwent hemodialysis between March 1943 and July 1944, 15 of whom died; a sole survivor may have benefited from dialysis. After a 14-mo hiatus enforced by the last battles of World War II, Kolff, on September 11, 1945, performed an 11.5-h dialysis on 80 L of blood, enabling his 17th patient, a 68-yr-old woman in coma attributed to the hepatorenal …

Increase in primitive stem cell numbers in equine peripheral blood following stress

Stout et al. (Amer Surg. 73:1106‐1110, 2007) reported base‐line levels of primitive stem cells circulating in adult porcine peripheral blood, which increased dramatically after just 90 minutes of trauma. Ongoing studies have shown similar stem cells in adult equine blood and that base‐line levels varied according to breed of the horse. The current study was undertaken to determine whether these stem cells would increase in number in the peripheral blood following stress in the same horse. Stress was defined as moderate exercise, i.e., 10 minutes of cantering. Blood withdrawal followed the guidelines of FVSU‐IACUC. Adult horses had 8 ml of blood withdrawn by venipuncture immediately prior to and immediately after exercising. After gravity separation, the plasma was withdrawn and 15 microliters of plasma from each sample was mixed with 15 microliters of 0.4% Trypan blue. The resultant solution was mixed, placed onto a hemocytometer and photographed: blastomere‐like stem cells (BLSCs) were Trypan blue positive and &lt; 2.0 microns in size; transitional‐BLSCs (Tr‐BLSCs) were both Trypan blue positive &amp; negative and 2‐5 microns in size; and epiblast‐like stem cells (ELSCs) were Trypan blue negative and 6‐8 microns in size (Young and Black, Minerva Biotech 17:55‐63, 2005). This study demonstrates that moderate exercise will increase the level of these primitive pluripotent stem cells in the blood of adult equines.

Red Wine Polyphenols Improve Endothelium-dependent Dilation in Rat Cerebral Arterioles

Moderate consumption of red wine is associated with a lower incidence of cardiovascular disease. Red wine polyphenols (RWP) have been proposed to be beneficial, but there is lack of evidence concerning the cerebrovascular effects of RWP. We studied the effect of local administration of a RWP extract (10(-2) mg/mL) on the diameter of rat cerebral arterioles using an open cranial window technique in vivo. We measured cerebral arteriolar diameter and systemic blood pressure. Cerebral arterioles reacted concentration-dependently to adenosine diphosphate [ADP, dilatation EC50 5.3 x 10(-5) M (95% confidence interval: 3.1 to 9.0 x 10 M(-5))], NG-nitro-L-arginine methyl ester [L-NAME, constriction EC50 5.8 x 10(-9) M (95% CI: 2.5 x 10(-9) to 1.4 x 10(-8) M)]. and sodium nitroprusside [SNP, dilatation EC50 1.0 x 10(-6) M (95% CI: 9.2 x 10(-7) to 1.1 x 10(-6) M)]. RWP enhanced vasodilation induced by ADP (10(-4) M) from 17 +/- 2% to 29 +/- 4% and reversed L-NAME-induced vasoconstriction but did not affect SNP-induced vasodilation. Systemic hypotension induced by hemorrhage caused myogenic arteriolar dilation. RWP further dilated cerebral arterioles (from -1 +/- 2% to 8 +/- 3%) with 1 mL of blood withdrawn. In summary, RWP improved endothelium-dependent and pressure-induced vasodilation in rat cerebral arterioles. This could be beneficial in improving cerebral blood flow under ischemic condition.

Markers of inflammation and myofibrillar proteins following eccentric exercise in humans.

The purpose of this study was to examine the time-course and relationships of technetium-99m (99mTc) neutrophils in muscle, interleukin-6 (IL-6), myosin heavy chain fragments (MHC), eccentric torque, and delayed onset muscle soreness (DOMS) following eccentric exercise in humans. Twelve male subjects completed a pre-test DOMS questionnaire, performed a strength test and had 100 ml blood withdrawn for analysis of plasma IL-6 and MHC content. The neutrophils were separated, labelled with 99mTc, and re-infused into the subjects immediately before the exercise. Following 300 eccentric repetitions of the right quadriceps muscles on an isokinetic dynamometer, the subjects had 10 ml of blood withdrawn with repeated the eccentric torque exercise tests and DOMS questionnaire at 0, 2, 4, 6, 20, 24, 48, 72 h, and 6 and 9 days. Bilateral images of the quadriceps muscles were taken at 2, 4, and 6 h. Computer analysis of regions of interest was used to determine the average count per pixel. The 99mTc neutrophils and IL-6 increased up to 6 h post-exercise (P < 0.05). The neutrophils were greater in the exercised muscle than the non-exercised muscle (P < 0.01). The DOMS was increased from 0 to 48 h, eccentric torque decreased from 2 to 24 h, and MHC peaked at 72 h post-exercise (P < 0.001). Significant relationships were found between IL-6 and 2 h and DOMS at 24 h post-exercise (r = 0.68) and assessment of the magnitude of change between IL-6 and MHC (r = 0.66). These findings suggest a relationship between damage to the contractile proteins and inflammation, and that DOMS is associated with inflammation but not with muscle damage.

ACUTE NORMOVOLEMIC HEMODILUTION IN PATIENTS UNDERGOING ELECTIVE MAJOR SURGERY

Efficacy of acute normovolemic hemodilution in patients undergoing elective major surgery was studied with the aim to evaluate optimum technique, safety and utility in the service. Forty adult patients undergoing elective major surgery, who were in ASA GD I with preoperative haemoglobin more than 10.0g% were included in this study after a detailed explanation of the procedure and obtaining consent. 350-700 ml of patients' blood was collected before induction of anaesthesia and was kept in the operation theatre at room temperature. This was followed by rapid infusion of crystalloid calculated at the rate of 3ml for every ml of blood withdrawn. Intraoperative blood loss, serial haemoglobin assessment, change in pulse rate, blood pressure, SpO2 and urine output were carefully monitored. The blood was reinfused once haemostasis was secured at the end of surgery. All the vital parameters were maintained within normal limits throughout the procedure. This simple, easy and inexpensive technique was found to be very useful in obviating the necessity of other forms of blood transfusion and preventing all transfusion related hazards. It was found that this method has an important role in patients with uncommon blood groups and has an excellent patient acceptability. This technique has an important role in peripheral service hospitals, where formal blood bank facilities do not exist.

Reliability of an intravenous intermittent access port (saline lock) for obtaining blood samples for coagulation studies

Patients admitted to rule out myocardial infarction often receive a heparin infusion that requires measurement of partial thromboplastin time every 6 to 8 hours until coagulation values stabilize. If the patient's acuity at admission does not necessitate placement of arterial or central catheters, insertion of an intermittent intravenous access port (saline lock) would decrease the need for frequent venipuncture. Many studies on obtaining blood samples via arterial and central catheters have been reported, but no reports have described the method of using a saline lock or the amount of blood discarded during that procedure. To evaluate the efficacy of inserting a saline lock specifically for obtaining blood samples and to determine the amount of blood that must be discarded in order to obtain prothrombin and partial thromboplastin times that match the values from blood samples obtained via venipuncture. Coagulation values determined with 2 consecutive blood samples obtained via the saline lock after the first 0.5 mL of blood withdrawn was discarded were compared with measurements determined with a blood sample obtained via venipuncture. Prothrombin and partial thromboplastin times were not significantly different among the 3 blood samples. The untoward effects of frequent venipunctures to obtain blood samples for measurement of prothrombin and partial thromboplastin times can be lessened by using an 18-gauge saline lock to obtain blood samples and discarding the first 0.5 mL of blood withdrawn before the samples for coagulation studies are collected.

Changes in plasma catecholamines during fever induced by bacterial endotoxin and interleukin-1 beta.

We have examined whether or not the release of catecholamines into the blood circulation of rabbits during fever is mediated by prostaglandins. The plasma levels of catecholamines (epinephrine and norepinephrine) were measured in 2 ml of blood withdrawn from the marginal ear vein. At an ambient temperature of 21 +/- 1 degree C, intravenous injection of either lipopolysaccharide (LPS, 4 micrograms/kg) or human recombinant interleukin-1 beta (rIL-1 beta, 1 microgram/kg) produced a biphasic fever accompanied by an increase in the plasma level of catecholamines. Pretreatment with intravenous indomethacin (1 mg/kg) markedly suppressed the increase in catecholamines induced by LPS and rIL-1 beta. In contrast, although intracerebroventricular injection of rIL-1 beta (20 ng) produced fever, it did not produce a significant change in plasma catecholamine levels. Similarly, intrahypothalamic injection of prostaglandin E2 (200, 800 ng) induced fever, but did not cause a significant change in catecholamine concentrations. These results suggest that IL-1 acts via prostaglandins on the peripheral tissues to release catecholamines into the circulation.

Effect of Paraquat Administration on Antioxidative Enzyme Activities and Oxidative Damage in the Blood and Liver of Senescence-accelerated Mice.

The effect was assessed of paraquat administration on the antioxidative defense mechanism in blood and liver. Ten-week-old senescence-accelerated mice were fed with either a 20% casein diet or the same diet supplemented with 200 ppm paraquat for 12 weeks. About 0.2 ml of blood withdrawn periodically from the supraorbital vein was assayed for the activities of antioxidative enzymes and oxidative damage. Blood and liver collected after decapitating the mice were equivalently treated at the end of the experimental period. Paraquat ingestion depressed the antioxidative enzyme activities, and increased the level of oxidized protein in erythrocytes and the thiobarbituric acid-reactive substance (TBARS) value in plasma. Similar changes were observed for the plasma and liver in the antioxidative enzyme activites, and in the level of oxidized protein and the TBARS value. These changes produced by paraquat administration were closely associated with accelerated aging leading to cell death. We discuss the effect of paraquat on senescence in mice, in relation to the oxidative damage caused.

Efficacy, complications, and cost of a comprehensive blood conservation program for cardiac operations

We reviewed blood use in 118 consecutive patients who underwent primary, elective cardiac operations in 1989. In June 1989 we initiated a blood conservation program that included attempts to limit preoperative aspirin use, intraoperative phlebotomy and hemodilution, use of a cell conservation device (Electromedics, Inc., Englewood, Colo.) to concentrate residual oxygenator contents, reinfusion of chest drainage, and acceptance of a minimum hemoglobin level of 8.0 gm/dl in stable patients. Patient characteristics were similar for patients operated on both before (n = 58) and after (n = 60) initiation of the blood conservation program, except for age and preoperative aspirin use (both greater in postconservation patients). Fewer blood products were transfused (5.8 +/- 5.7 units per patient before conservation versus 4.0 +/- 7.4 units per patient after conservation; p = 0.005). More complete data were available for 82 patients (40 patients before conservation and 42 after conservation). In the postconservation patients, 20 of 42 had 575 +/- 140 ml of blood withdrawn before cardiopulmonary bypass and reinfused afterward, 26 of 42 had 806 +/- 376 ml of blood processed with the cell conservation device returned, and 21 of 42 patients had an average of 287 +/- 127 ml of chest drainage reinfused. Chest tube drainage, postoperative hematologic parameters, and the prevalence of complications were not significantly different between groups. Stepwise linear regression analysis identified intraoperative withdrawal of blood before cardiopulmonary bypass, bypass duration, and preoperative hematocrit value as predictors of blood use. Intraoperative withdrawal of blood before cardiopulmonary bypass is an important conservation measure, and its use should be expanded.

Erythrocyte survival following extracorporeal circulation: A question of membrane versus bubble oxygenator

Five groups of seven dogs were studied. Each animal had 250 ml of blood withdrawn and tagged with Cr51. Group I (control) samples were combined with 500 ml of lactated Ringer's solution and reinfused into the respective animals after 3 hours of incubation at 37 degrees C. Group II samples were pumped in a closed-circuit bubble oxygenator with 500 ml of lactated Ringer's prime for 2 hours before reinfusion into the animals. Group III samples were pumped in a bubble oxygenator for 3 hours before reinfusion. Group IV samples were pumped in a closed-circuit membrane oxygenator for 2 hours, and Group V samples were pumped in a membrane circuit for 3 hours. All extracorporeal pump runs were performed at 37 degrees C. Blood samples were drawn from the dogs at regular intervals after bypass for 30 days. Erythrocyte survival was determined by Cr51 activity recorded by a gamma counter. The red cell half-life was determined for each dog. The control half-life was 24.1 +/- 2.03 days; Group II, 19.88 +/- 1.69 (p < 0.05); Group III, 9.63 +/- 1.4 (p < 0.001); Group IV, 19.4 +/- 1.65 (p < 0.05); and Group V, 9.13 +/- 1.45 (p < 0.001). These data indicate that serious red cell injury does occur with extracorporeal circulation but that the injury is a function of pump time, rather than of the type of oxygenator.