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Red blood cell transfusion and skeletal muscle tissue oxygenation in anaemic haematologic outpatients

View Article: PubMed Central - PubMed

ABSTRACT

Background: Stored red blood cells (RBCs) accumulate biochemical and biophysical changes, known as storage lesion. The aim of this study was to re-challenge current data that anaemia in chronically anaemic haematology patients is not associated with low skeletal muscle tissue oxygen (StO2), and that RBC storage age does not influence the tissue response after ischaemic provocation, using near-infrared spectroscopy.

Patients and methods: Twenty-four chronic anaemic haematology patients were included. Thenar skeletal muscle StO2 was measured at rest (basal StO2), with vascular occlusion testing (upslope StO2, maximum StO2) before and after transfusion.

Results: Basal StO2 was low (53% ± 7%). Average RBC storage time was 10.5 ± 3.9 days. Effects of RBC transfusions were as follows: basal StO2 and upslope StO2 did not change significantly; maximum StO2 increased compared to baseline (64 ± 14% vs. 59 ± 10%, p = 0.049). Change of basal StO2, upslope StO2 and maximum StO2 was negatively related to age of RBCs. The decrease of maximum StO2 was predicted (sensitivity 70%, specificity 100%), after receiving RBCs ≥ 10days old.

Discussion: Resting skeletal muscle StO2 in chronic anaemic patients is low. RBC storage time affects skeletal muscle StO2 in the resting period and after ischaemic provocation.

No MeSH data available.


Related in: MedlinePlus

Schematic presentation of thenar skeletal muscle StO2 before, during and after the vascular occlusion tests. Before the vascular occlusion, the StO2 is measured in the resting period (1, basal StO2). During the vascular occlusion, the StO2 gradually decreases. The rate of this decrease is determined from the curve as the downslope StO2 (2; %/min), as a surrogate of the tissue oxygen consumption. After reaching the predetermined minimum StO2, present here as 40% StO2 (3), the vascular occlusion is released, and the StO2 begins to rise again. The rate of this increase is determined from the curve as the upslope StO2 (4; %/min), as a surrogate marker of the microcirculatory reactivity. After the release of the occlusion, the StO2 increases to higher values compared to the basal StO2 due to post-ischaemic vasodilatation (5, maximum StO2). The StO2 then slowly returns to the basal StO2.
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j_raon-2015-0046_fig_001: Schematic presentation of thenar skeletal muscle StO2 before, during and after the vascular occlusion tests. Before the vascular occlusion, the StO2 is measured in the resting period (1, basal StO2). During the vascular occlusion, the StO2 gradually decreases. The rate of this decrease is determined from the curve as the downslope StO2 (2; %/min), as a surrogate of the tissue oxygen consumption. After reaching the predetermined minimum StO2, present here as 40% StO2 (3), the vascular occlusion is released, and the StO2 begins to rise again. The rate of this increase is determined from the curve as the upslope StO2 (4; %/min), as a surrogate marker of the microcirculatory reactivity. After the release of the occlusion, the StO2 increases to higher values compared to the basal StO2 due to post-ischaemic vasodilatation (5, maximum StO2). The StO2 then slowly returns to the basal StO2.

Mentions: In this resting period before the transfusion and after StO2 signal stabilisation, the basal StO2(%) and THb(g/l) were determined. Then vascularocclusion test was performed, as reported previously.6 In short, a sphygmomanometer cuff was placed over the brachium, and the pressure cuff inflation was taken to 60 mmHg over systolic blood pressure, to stop the blood flow in brachial artery. The StO2 decreased during this arterial occlusion, which was measured as the downslope StO2 (%/min). After reaching a StO2 of 40% (the minimum StO2) the cuff was released, and the StO2 and THb continuously measured for an additional 5 min (Figure 1). During this reperfusion, the StO2 increased rapidly, as the upslope StO2 (%/min), and usually reached values higher than the basal StO2, to give the maximum StO2 (%). The same procedure was carried out 30 min after the RBC transfusion.Figure 1


Red blood cell transfusion and skeletal muscle tissue oxygenation in anaemic haematologic outpatients
Schematic presentation of thenar skeletal muscle StO2 before, during and after the vascular occlusion tests. Before the vascular occlusion, the StO2 is measured in the resting period (1, basal StO2). During the vascular occlusion, the StO2 gradually decreases. The rate of this decrease is determined from the curve as the downslope StO2 (2; %/min), as a surrogate of the tissue oxygen consumption. After reaching the predetermined minimum StO2, present here as 40% StO2 (3), the vascular occlusion is released, and the StO2 begins to rise again. The rate of this increase is determined from the curve as the upslope StO2 (4; %/min), as a surrogate marker of the microcirculatory reactivity. After the release of the occlusion, the StO2 increases to higher values compared to the basal StO2 due to post-ischaemic vasodilatation (5, maximum StO2). The StO2 then slowly returns to the basal StO2.
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Related In: Results  -  Collection

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j_raon-2015-0046_fig_001: Schematic presentation of thenar skeletal muscle StO2 before, during and after the vascular occlusion tests. Before the vascular occlusion, the StO2 is measured in the resting period (1, basal StO2). During the vascular occlusion, the StO2 gradually decreases. The rate of this decrease is determined from the curve as the downslope StO2 (2; %/min), as a surrogate of the tissue oxygen consumption. After reaching the predetermined minimum StO2, present here as 40% StO2 (3), the vascular occlusion is released, and the StO2 begins to rise again. The rate of this increase is determined from the curve as the upslope StO2 (4; %/min), as a surrogate marker of the microcirculatory reactivity. After the release of the occlusion, the StO2 increases to higher values compared to the basal StO2 due to post-ischaemic vasodilatation (5, maximum StO2). The StO2 then slowly returns to the basal StO2.
Mentions: In this resting period before the transfusion and after StO2 signal stabilisation, the basal StO2(%) and THb(g/l) were determined. Then vascularocclusion test was performed, as reported previously.6 In short, a sphygmomanometer cuff was placed over the brachium, and the pressure cuff inflation was taken to 60 mmHg over systolic blood pressure, to stop the blood flow in brachial artery. The StO2 decreased during this arterial occlusion, which was measured as the downslope StO2 (%/min). After reaching a StO2 of 40% (the minimum StO2) the cuff was released, and the StO2 and THb continuously measured for an additional 5 min (Figure 1). During this reperfusion, the StO2 increased rapidly, as the upslope StO2 (%/min), and usually reached values higher than the basal StO2, to give the maximum StO2 (%). The same procedure was carried out 30 min after the RBC transfusion.Figure 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Stored red blood cells (RBCs) accumulate biochemical and biophysical changes, known as storage lesion. The aim of this study was to re-challenge current data that anaemia in chronically anaemic haematology patients is not associated with low skeletal muscle tissue oxygen (StO2), and that RBC storage age does not influence the tissue response after ischaemic provocation, using near-infrared spectroscopy.

Patients and methods: Twenty-four chronic anaemic haematology patients were included. Thenar skeletal muscle StO2 was measured at rest (basal StO2), with vascular occlusion testing (upslope StO2, maximum StO2) before and after transfusion.

Results: Basal StO2 was low (53% ± 7%). Average RBC storage time was 10.5 ± 3.9 days. Effects of RBC transfusions were as follows: basal StO2 and upslope StO2 did not change significantly; maximum StO2 increased compared to baseline (64 ± 14% vs. 59 ± 10%, p = 0.049). Change of basal StO2, upslope StO2 and maximum StO2 was negatively related to age of RBCs. The decrease of maximum StO2 was predicted (sensitivity 70%, specificity 100%), after receiving RBCs ≥ 10days old.

Discussion: Resting skeletal muscle StO2 in chronic anaemic patients is low. RBC storage time affects skeletal muscle StO2 in the resting period and after ischaemic provocation.

No MeSH data available.


Related in: MedlinePlus