Leukodepleted versus nonleukodepleted red blood cell transfusion in septic patients: a microcirculatory vision

نویسندگان

  • Sebastien Tanaka
  • Anatole Harrois
  • Jacques Duranteau
چکیده

Storage time and residual leukocytes in red blood cell (RBC) units may be deleterious by increasing the accumulation of leukocyte-derived cytokines and by raising the adhesion of RBCs to endothelium. Leukodepleted RBC transfusion may reduce the incidence of infection and organ dysfunction. However, the influence of leukodepletion on microcirculation remains not well defined in ICU patients. In this context, an original study in a previous issue of Critical Care emphasizes the microcirculatory effects of transfusion of leukodepleted RBCs (post-storage leukoreduction) or nonleukodepleted RBCs in septic patients. This study suggests a positive rheological impact of leukodepleted RBCs in septic patients with an increase in sublingual microvascular flow and perfused vessel density. Given the variability in the microvascular response to RBC transfusion in individual patients, there is a need for monitoring the microcirculation to guide transfusion in patients with sepsis rather than deciding to transfuse RBCs according to an arbitrary hemoglobin level. Further studies to identify the microvascular response to RBC transfusion in ICU patients are warranted.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Microcirculatory effects of the transfusion of leukodepleted or non-leukodepleted red blood cells in patients with sepsis: a pilot study

INTRODUCTION Microvascular alterations impair tissue oxygenation during sepsis. A red blood cell (RBC) transfusion increases oxygen (O2) delivery but rarely improves tissue O2 uptake in patients with sepsis. Possible causes include RBC alterations due to prolonged storage or residual leukocyte-derived inflammatory mediators. The aim of this study was to compare the effects of two types of trans...

متن کامل

Non-leukodepleted red blood cell transfusion in sepsis patients: beyond oxygenation, is there a risk of inflammation?

Donati and colleagues [1] evaluated the benefits of fresh, leukodepleted (LD) versus non-leukodepleted (nLD) erythrocyte transfusions on the microcirculation in sepsis patients. Oxygenation appeared equal in both groups. Differences between the two kinds of blood cells are presented in Table 1. In the reported study, there is a difference between the age of erythrocytes in the two groups (1.5 t...

متن کامل

Transfusion of Red Blood Cells to Patients with Sepsis

Sepsis is one of the major causes of death worldwide, and is the host response to infection which renders our organs malfunctioning. Insufficient tissue perfusion and oxygen delivery have been implicated in the pathogenesis of sepsis-related organ dysfunction, making transfusion of packed red blood cells (pRBCs) a reasonable treatment modality. However, clinical trials have generated controvers...

متن کامل

Comparing Electrolytes in Prestorage Leukocyte-Reduced Packed Cell versus Unfiltered Packed Cell

Abstract Background Blood transfusion is associated with side effects caused by residual leukocytes in blood and blood components. Using leukodepleted blood components can decrease some of these adverse effects. Among the various methods to remove leukocytes in blood components, prestorage leukoreduction has been most efficient, but the evidence of clinical side effects awaits further studies...

متن کامل

Leukocytes in blood transfusion: adverse effects and their prevention.

Leukocyte contamination during blood transfusion can cause many adverse effects, such as the transmission of cell-associated infectious agents, febrile non-haemolytic reactions, graft-versus-host disease, and immunosuppression. While using leukodepleted blood components can minimise some of these adverse effects, the leukodepletion of all cellular blood components is costly. A more cost-effecti...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 18  شماره 

صفحات  -

تاریخ انتشار 2014