A Mechanistic Analysis of Possible Blood Transfusion Failure to Increase Circulatory Oxygen Delivery in Anemic Patients.
Ann Biomed Eng
; 47(4): 1094-1105, 2019 Apr.
Article
en En
| MEDLINE
| ID: mdl-30659435
ABSTRACT
The effects of changing hematocrit (Hct) on the rate of circulatory oxygen ([Formula see text]) delivery were modeled analytically to describe transfusion of 0.5-3.0 units of packed red blood cells (pRBC, 300 mL/unit, 60% Hct) to anemic patients. In our model, Hct affects [Formula see text] delivery to the microcirculation by changing blood [Formula see text] carrying capacity and blood viscosity, which in turn affects blood flow velocity and, therefore, [Formula see text] delivery. Changing blood velocity impacts the [Formula see text] delivery by affecting the oxygen diffusive losses as blood transits through the arteriolar vasculature. An increase in Hct has two opposite effects it increases the blood [Formula see text] carrying capacity and decreases the flow velocity. This suggests the existence of an optimal Hct that maximizes [Formula see text] delivery. Our results show that maximal [Formula see text] delivery occurs in the anemic range, where [Formula see text]%. Optimal blood management is associated with transfusing enough units up to reaching maximal [Formula see text] delivery. Although somewhat complex to implement, this practice would result in both substantial blood savings and improved [Formula see text] delivery.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Oxígeno
/
Transfusión Sanguínea
/
Reacción a la Transfusión
/
Anemia
Límite:
Humans
Idioma:
En
Revista:
Ann Biomed Eng
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos