Carrillo ER, Sánchez GR

Language: Spanish
References: 25
Page: 63-67
PDF size: 111.53 Kb.

ABSTRACT

The resuscitation with crystalloids and erythrocytic concentrates are associated with acid-base alterations. By Stewart physical-chemical model some of the consequences of overeanimation, as volume expansion, decline in serum potassium and hyperchloremic metabolic acidosis could be explained. The injury secondary to storage lesion erythrocytes is causing the low oxygen supply and injury to the microcirculation, which determines the decrease in P50 and lactic acidosis. The aim of this study is based on the case of a patient with a bleeding hypovolemic shock, to report deletereous effects of overesuscitation and the use of red cell concentrates with prolonged storage.

REFERENCES

1. Fencl V, Leith DE. Stewart’s quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol 1993; 91: 1-16.

2. Grocott MPW, Mythen MG, Gan TJ. Perioperative fluid management and clinical outcomes in adults. Anesth Anal 2005; 100: 1093–1106.

3. Beutler E, West C. Storage of red cell concentrates in CPDA2 for 42 and 49 days. J Lab Clin Med 1983; 102: 53-62.

4. Greenwalt TJ, Zehner SC, Dumaswala UJ. Studies in red blood cell preservation. 2. Comparison of vesicle formation, morphology, and membrane lipids during storage in AS-1and CPDA-1. Vox Sang 1990; 58: 90-3.

5. Dumaswala UJ, Dumaswala RU, Levin DS, et al. Improved red blood cell preservation correlates with decreased loss of bands 3, 4.1, acetylcholinesterase, and lipids in microvesicles. Blood 1996; 87: 1612-6.

6. Dumaswala UJ, Rugg N, Greenwalt TJ. Studies in red blood cell preservation: 9. The role of glutamine in red cell preservation. Vox Sang 1994; 67: 255-9.

7. Wolfe L, Byrne A. A protection of red cell membrane from injury during liquid preservation of erythrocytes. Blood 1985; 66: 41A.

8. Knight JA, Searles DA, Clayton FC. The effect of desferrioxamine on stored erythrocytes. lipid peroxidation, deformability, and morphology. Ann Clin Lab Sci 1996; 26: 283-90.

9. Messana I, Ferroni L, Misiti F et al. Blood bank conditions and RBCs: the progressive loss of metabolic modulation. Transfusion 2000; 40: 353-60.

10. Tsai AG, Cabrales P, Intaglietta M. Microvascular perfusion upon exchange transfusion with stored red blood cells in normovolemic anemic conditions. Transfusion 2004; 44: 1626-34.

11. Hurd TC, Dasmahapatra KS, Rush BF et al. Red blood cell deformability in human and experimental sepsis. Arch Surg 1988; 123: 217-20.

12. Langenfeld JE, Livingston DH, Machiedo GW. Red cell deformability is an early indicator of infection. Surgery 1991; 110: 398-404.

13. Baker CH, Wilmoth FR, Sutton ET. Reduced RBC versus plasma microvascular flow due to endotoxin. Circ Shock 1986; 20: 127-39.

14. Mollitt DL, Poulos ND. The role of pentoxifylline in endotoxin-induced alterations of red cell deformability and whole blood viscosity in the neonate. J Pediatr Surg 1991; 26: 572-4.

15. Powell RJ, Machiedo GW, Rush BF Jr et al. Oxygen free radicals: effect on red cell deformability in sepsis. Crit Care Med 1991; 19: 732-5.

16. Hersch M, Gnidec AA, Bersten AD et al. Histologic and ultrastructural changes in nonpulmonary organs during early hyperdynamic sepsis. Surgery 1990; 107: 397-410.

17. De Backer D, Creteur J, Preiser JC et al. Microvascular blood flow is altered in patients with sepsis. Am J Respir Crit Care Med 2002; 166: 98-104.

18. Hersch M, Bersten AD, Rutledge FS et al. Quantitative evidence of microcirculatory compromise in skeletal muscle of normotensive hyperdynamic septic sheep. Crit Care Med 1989; 17: S60.

19. Marik PE, Sibbald WJ. Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993; 269: 3024-9.

20. Messmer K, Kreimeier U, Intaglietta M. Present state of intentional hemodilution. Eur Surg Res 1986; 18: 254-63.

21. Messmer KF. Acceptable hematocrit levels in surgical patients [review]. World J Surg 1987; 11: 41-6.

22. Fitzgerald R, Potter RF, Dietz G et al. The effect of transfusing aged red blood cells in oxygen supply dependency. Chest 1994; 106: 55S.

23. Sielenkamper AW, Chin-Yee IH, Martin CM et al. Diaspirin crosslinked hemoglobin improves systemic oxygen uptake in oxygen supply-dependent septic rats. Am J Respir Crit Care Med 1997; 156: 1066-72.

24. van Bommel J, de Korte D, Lind A et al. The effect of the transfusion of stored RBCs on intestinal microvascular oxygenation in the rat. Transfusion 2001; 41: 1515-23.

25. Scheingraber S, Rehm M, Sehmisch C,Finsterer U. Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery. Anesthesiology 1999; 90: 1265–1270.