Effect of Acute Normovolemic Hemodilution Combined with Controlled Low Central Venous Pressure on Blood Coagulation Function and Blood Loss in Patients Undergoing Resection of Liver Cancer Operation.

BACKGROUND/AIMS: This paper aims to investigate the effect of acute normovolemic hemodilution (ANH) used with controlled low central venous pressure (LCVP) technology on perioperative bleeding and coagulation in hepatocellular carcinoma operation patients. METHODOLOGY: A total of 60 cases undergoing hepatic resection operation were randomly divided into the control group, LCVP group (Group II), and ANH + LCVP group (Group III). The changes of hemodynamic indexes at different time points in each group were observed and recorded, along with the volume of allogenous blood transfusion and the number of patients undergoing allogenous blood transfusion. RESULTS: Compared with Group I (control), there was evident reduction of the bleeding volume, allogenic blood transfusion volume, and number of patients undergoing allogenic blood transfusion in Groups II and III. CONCLUSION: The application of ANH combined with LCVP in hepatic resection can evidently reduce intraoperative hemorrhages and homologous blood transfusions; moreover, it has no significant adverse effect on the coagulation function.

The effect of different storage times on the oxygen-carrying capacity of the exosomes of red blood cells.

BACKGROUND: After storing blood for a period of time, the structure and properties of the red blood cells (RBC) will change, which results in a decrease in the oxygen-carrying capacity, and further has a certain impact on their exosomes. OBJECTIVES: Effective oxygen uptake (Q), P50, 2,3-DPG, and Na+-K+-ATP of RBC after different storage times were detected. Electron microscopy was used to observe the morphology of RBC and the characteristics of secreting exosomes. Western blot was used to detect the expression of phenotypes CD63 and CD81 of exosomes, and the expression of mitochondrial riboprotein MRPS35 of exosomes was also detected to explore the mechanism of decreased function of RBC with the extension of preservation time. MATERIAL AND METHODS: After the RBC suspension was prepared, the effective oxygen-carrying capacity (Q) and P50, as well as 2,3-DPG and Na+-K+-ATP were prepared. This was followed by morphology observation of erythrocyte exosomes using transmission electron microscope (TEM), and by western blot analysis of exosome phenotypes CD63 and CD81. RESULTS: Erythrocytes secrete exosomes, which results in abnormal expression of related proteins in mitochondria. This leads to increased ROS production, mitochondrial apoptosis and, finally, changes in or damage to erythrocytes. CONCLUSIONS: Changes in the rheological properties and oxygen-carrying functions of erythrocytes during preservation are all observable manifestations, and underlying these manifestations are mechanisms of damage to erythrocytes at a molecular level. Erythrocytes secrete exosomes, which results in abnormal expression of related proteins in mitochondria, increasing ROS production, mitochondrial apoptosis and, finally, changes or damage to erythrocytes.