PubMed Health⌕ Search

Biomedical subjects

D E Clare

Publications and source records attributed to D E Clare.

4 recordsLinked to original sources
PubMed1990

Minimal-exposure transfusion and the committed donor.

Autologous blood (collected preoperatively or salvaged intraoperatively) is the safest blood available for transfusion, but its use is not always feasible. It may be possible to decrease a patient's exposure to homologous donors. Pediatric cardiac surgery patients frequently are unable to donate autologous blood preoperatively. Since 1984, attempts have been made to provide parental apheresis platelets and intraoperative blood salvage to such patients to decrease their donor exposure. Further decreases in donor exposure have been the object of a program of collecting from one committed donor all the blood a patient is anticipated to need. This article reviews the experience with 50 pediatric cardiac surgery patients on such a program, in whom the mean decrease in homologous-donor exposure was 57 percent (range, 12-93%). Thirteen of these patients received only homologous blood products from one committed donor, for a mean decrease in homologous-donor exposure of 80 percent (range, 50-93%). A comparison of 12 of these 13 recipients with a matched control group showed no significant difference in red cell transfusion practice but a significant difference in the number of homologous-donor exposures per m2 of body surface area (BSA) (mean donor exposures/m2 of BSA: patients = 1.5, controls = 10.5). The use of one committed donor and autologous blood can provide a minimal-exposure transfusion.

Adolescent↗
PubMed1987

Infusion flow rates of whole blood and AS-1-preserved erythrocytes: a comparison.

We compared the flow rates of whole blood and erythrocytes resuspended in a new preservative solution (AS-1, consisting of adenine, dextrose, mannitol, and saline) which results in an erythrocyte preparation with a hematocrit lower than that of packed erythrocytes. When 100 ml of AS-1 solution is added to erythrocytes, a hematocrit of 59 +/- 5% is consistently obtained, and the resultant product has an improved flow rate. When we compared the infusion flow rates of whole blood and AS-1-preserved erythrocytes in vitro and in vivo, we found that flow times were shorter for AS-1 erythrocytes than for whole blood in vitro and in vivo, the flow rates of AS-1 erythrocytes and whole blood when expressed per volume were similar in vivo, and the flow rate of AS-1 erythrocytes for erythrocyte mass delivery in vivo was superior to that of whole blood. Thus, we conclude that the flow rates of the two products are comparable.

Adenine↗
PubMedDate not supplied

Viability and functional integrity of washed platelets.

The viability and functional integrity of saline- and ACD-saline-washed platelets were compared with those of unwashed platelets. After template bleeding time (TBT) was measured, 15 healthy volunteers underwent plateletpheresis and ingested 600 mg of aspirin. Autologous 111In-labeled platelets were transfused: unwashed (n = 5), washed with 0.9 percent saline solution (SS) (n = 5), and washed with a buffered 12.6 percent solution of ACD-A in 0.9 percent saline solution (n = 5). After transfusion, we measured TBT at 1, 4, and 24 hours; platelet survival at 10 minutes and 1, 4, and 24 hours and daily for 6 days; and the percentage of uptake in liver and spleen by quantitative whole-body radionuclide scintigraphy at 24 and 190 hours. We found that saline washing affected platelet recovery, 23.47 +/- 12 percent (p less than 0.001) as compared to 52.43 +/- 17 percent (p less than 0.002) for ACD-saline and 73.17 +/- 8 percent for control; that saline washing resulted in a greater liver uptake than control and ACD-saline-washed platelets (31.9 +/- 8% [p less than 0.001] vs 17.7 +/- 4.1 and 19.3 +/- 2.1% [p greater than 0.1], respectively); that, unlike control and ACD-saline-washed platelets, saline-washed platelets did not shorten bleeding time; and that neither type of washing affected survival. Although ACD-saline washing affects recovery, it also results in intact function, normal survival, higher recovery than SS platelets, and no significant liver uptake.

Bleeding Time↗