Search

Introduction Impact of blood donor characteristics on quality of packed red blood cell concentrates. Objective To determine the impact of donor factors on the quality of packed red blood cell concentrates. Material and methods The analytical cross sectional study was conducted on 505 whole blood donors after approval by the Institutional Ethics Committee and written informed consent from blood donors. Two mL EDTA sample was collected for pre-donation haemoglobin estimation and all relevant donor details were recorded. Whole blood was collected in 350 mL double blood bags. PRBCs were prepared as per the departmental SOP. Volume of each PRBC was recorded and sample from each bag was taken for estimation of total haemoglobin content and haematocrit. Results Of 505 blood donors, 459 (90.9%) were males and 324 donors (64.2%) were less than 30 years of age. The majority of the donors were repeat donors (61%, n = 308 repeat donors), vegetarians (52.9%, n = 267 vegetarians) and non-smokers (92.7%, n = 468). Mean haemoglobin was found to be significantly higher in males (14.9 vs. 13.3; P ≤ 0.001), donors more than 30 years of age (15 vs. 14.7; P = 0.042), repeat donors (14.9 vs. 14.7), non-vegetarians (15.1 vs. 14.6; P ≤ 0.001) and smokers (15.3 vs. 14.8 g/dL; P = 0.020). PRBC units prepared from male blood donors, repeat donors and non vegetarians had significantly higher mean volume and mean total haemoglobin content. Strong positive correlation was observed between haemoglobin of the blood donor and total haemoglobin content of the PRBC and volume of blood collected. Conclusions Donor characteristics do have effect on total haemoglobin content of packed red blood cells.

International audience; Background and purpose: Better characterization of the thrombus could be useful to determine acute ischaemic stroke (AIS) aetiology and predict response to thrombolysis and endovascular therapy (EVT). To test the hypothesis that susceptibility vessel sign (SVS) on baseline magnetic resonance imaging (MRI) is related to red blood cell (RBC) content of AIS thrombi, the total haemoglobin contents (HbCs) of AIS thrombi retrieved by EVT from patients with or without SVS or two-layered SVS (TLSVS) were compared. Methods: Baseline MRI of 84 anterior AIS patients was reviewed by neuro-radiologists blinded to clinical and biochemical data. Thrombi from these patients were retrieved by EVT and analysed for HbC by quantitative enzyme-linked immunosorbent assay and measurement of haem concentration. Results: Susceptibility vessel sign and TLSVS were respectively observed in 85.7% and 50.0% of cases. The median HbC content was 253 µg/mg thrombus (interquartile range 177–333) and the median haem content was 219 µg/mg thrombus (131–264). Thrombus HbC and haem content were highly correlated with thrombus RBC content determined by flow cytometry (r = 0.94). Thrombi from patients with TLSVS weighed more [31.1 (16.5–68.3) mg vs. 17.7 (11.7–33.3) mg; P = 0.005] and had a higher HbC content [278 (221–331) µg/mg vs. 196 (139–301) µg/mg; P = 0.010] compared to thrombi from patients without TLSVS. There was no difference in thrombus weight or HbC content according to SVS status. Conclusions: Our study shows that TLSVS is significantly associated with a higher thrombus weight and RBC content, as determined by quantitative assays.

IntroductionPhotoacoustic imaging (PAI) enables the detection of blood haemoglobin (HB) concentration and oxygenation (SO2) with high contrast and resolution. To date, the relationship between photoacoustically determined total Haemoglobin (THbMSOT) and oxygen saturation (SO2) biomarkers and the underlying biochemical blood parameters has yet to be established. We sought to explore these relationships in a species-specific manner.MethodsExperiments were performed in vitro using tissue-mimicking agar phantoms. Blood was extracted from mouse, rat, human and naked mole-rat (Heterocephalus glaber), anticoagulated in EDTA and measured within 48 hours. THbMSOT and SO2MSOT were measured using a commercial photoacoustic tomography system (InVision 128, iThera Medical GmBH). Biochemical blood parameters such as haemoglobin concentration (HB, g/dL), haematocrit (HCT, %) and red blood cell count (RBC, μL-1) were assessed using a haematology analyser (Mythic 18 Vet, Woodley Equipment).ResultsA significant correlation was observed between THbMSOT and biochemical HB, HCT and RBC in mouse and rat blood. Moreover, PAI accurately recapitulated inter-species variations in HB and HCT between mouse and rat blood and resolved differences in the oxygen dissociation curves between human, mouse and rat. With these validation data in hand, we applied PAI to studies of blood obtained from naked mole-rats and could confirm the high oxygen affinity of this species in comparison to other rodents of similar size.ConclusionIn summary, our results demonstrate the high sensitivity of photoacoustically determined biomarkers towards species-specific variations in vitro.

NEW FINDINGS What is the central question of this study? Does ischaemic preconditioning (IPC) influence central and peripheral fatiguing mechanisms during sustained maximal isometric exercise? What is the main finding and its importance? Voluntary activation and pre- to postexercise reductions in resting twitch torque values were unchanged by IPC. However, an effect on tissue oxygenation was observed within the IPC trials, where greater concentrations of deoxyhaemoglobin were recorded with concurrent upward trends of total haemoglobin concentrations. Using a direct assessment of neural drive, we found that IPC had no influence on either central or peripheral fatiguing pathways after maximal isometric exercise. ABSTRACT Ischaemic preconditioning (IPC) is thought to inhibit neural feedback from metabolically sensitive muscle afferents during exercise. It was hypothesized that IPC could affect mechanisms associated with centrally mediated fatigue after a maximally fatiguing protocol. Eleven resistance-trained men completed three 2 min maximal voluntary contractions (MVCs) via an isometric leg extension preceded by treatments of IPC (three bouts of 5 min bilateral leg occlusions at 220 mmHg), SHAM (three bouts of 5 min at 20 mmHg) or CON (30 min passive rest). Femoral nerve stimulation was used to explore central and peripheral fatigue pathways. These pathways were profiled at baseline (BL), before the 2 min MVC (Pre) and 10 s afterwards (Post). Tissue oxygenation was measured throughout the 2 min MVCs via near-infrared spectroscopy. The Pre to Post MVC (-71 ± 56 Nm; d = 1.33 ± 0.51, P

Background Cardiopulmonary exercise testing (CPET) measures peak exertional oxygen consumption ( V ˙ O 2 peak ) and that at the anaerobic threshold ( V ˙ O 2 at AT, i.e. the point at which anaerobic metabolism contributes substantially to overall metabolism). Lower values are associated with excess postoperative morbidity and mortality. A reduced haemoglobin concentration ([Hb]) results from a reduction in total haemoglobin mass (tHb-mass) or an increase in plasma volume. Thus, tHb-mass might be a more useful measure of oxygen-carrying capacity and might correlate better with CPET-derived fitness measures in preoperative patients than does circulating [Hb]. Methods Before major elective surgery, CPET was performed, and both tHb-mass (optimized carbon monoxide rebreathing method) and circulating [Hb] were determined. Results In 42 patients (83% male), [Hb] was unrelated to V ˙ O 2 at AT and V ˙ O 2 peak (r=0.02, P=0.89 and r=0.04, P=0.80, respectively) and explained none of the variance in either measure. In contrast, tHb-mass was related to both (r=0.661, P

Blood flow changes in response to exercise have been attributed, among other factors, to the effect of vasodilators factors on the microvasculature, suggesting a close relationship between small blood vessels and conducting arteries. The main purpose of this study was to determine the relationship between the changes in near infrared spectroscopy (NIRS)-derived total haemoglobin ([tHb]) and muscle oxygen saturation (SmO

Background Non-invasive monitoring of cerebral tissue oxygen saturation (rcSO2) during transition is of growing interest. Different near-infrared spectroscopy (NIRS) techniques have been developed to measure rcSO2. We compared rcSO2 values during the immediate transition in preterm neonates measured with frequency-domain NIRS (FD-NIRS) with those measured with continuous-wave NIRS (CW-NIRS) devices in prospective observational studies. Methods We compared rcSO2 values measured with an FD-NIRS device during the first 15 min after birth in neonates with a gestational age ≥ 30 weeks but 2 measurements, with fixed effects for time (non-linear), device, respiratory support and the interaction of device and respiratory support with time. Additionally, parameters such as total haemoglobin concentration and oxygenated and deoxygenated haemoglobin concentrations measured by FD-NIRS were analysed. Results Thirty-eight FD-NIRS measurements were compared with 58 CW-NIRS measurements. The FD-NIRS rcSO2 values were consistently higher than the CW-NIRS rcSO2 values in the first 12 min, irrespective of respiratory support. After adjustment for respiratory support, the time-dependent trend in rcSO2 differed significantly between techniques (p Conclusion As cerebral saturation measured with the FD-NIRS device differed significantly from that measured with the CW-NIRS device, differences in absolute values need to be interpreted with care. Although FD-NIRS devices have technical advantages over CW-NIRS devices, FD-NIRS devices may overestimate true cerebral oxygenation and their benefits might not outweigh the usability of the more clinically viable CW-NIRS devices.

BACKGROUND Reference intervals for arterial and venous umbilical cord blood gas (UCBG) parameters are scarce, are mainly focused on pH, pO2, pCO2 and base deficit, and are usually assessed using parametric tests, despite a generally skewed data distribution. Here, the purpose is to determine reference percentiles for nine parameters of concomitant arterial and venous UCBG (CAV-UCBG) from neonates at birth, using nonparametric tests. METHODS Results of CAV-UCBG, assayed over a 4.5-year period, were extracted from a hospital laboratory database for pH, pCO2, pO2, oxygen saturation, concentration of total oxygen, total carbon dioxide, hydrogen carbonate, total haemoglobin, and acid-base excess. Exclusion criteria were: a venous-arterial pH difference

Acute exercise-induced improvements in cognitive function are accompanied by increased (cerebral) blood flow and increased brain-derived neurotrophic factor (BDNF) levels. Acute cocoa flavanol (CF) intake may improve cognitive function, cerebral blood flow (in humans), and BNDF levels (in animals). This study investigated (i) the effect of CF intake in combination with exercise on cognitive function and (ii) cerebral hemodynamics and BDNF in response to CF intake and exercise. Twelve healthy men participated in this randomized, double-blind, crossover study. Participants performed a cognitive task (CT) at 100 min after acute 903-mg CF or placebo (PL) intake, followed by a 30-min time-trial. Immediately after this exercise, the same CT was performed. Prefrontal near-infrared spectroscopy was applied during CT and exercise to measure changes in oxygenated (ΔHbO2), deoxygenated (ΔHHb), and total haemoglobin (ΔHbtot) and blood samples were drawn and analyzed for BDNF. Reaction time was faster postexercise, but was not influenced by CF. ΔHbO2 during the resting CT was increased by CF, compared with PL. ΔHbO2, ΔHHb, and ΔHbtot increased in response to exercise without any effect of CF. During the postexercise cognitive task, there were no hemodynamic differences between CF or PL. Serum BDNF was increased by exercise, but was not influenced by CF. In conclusion, at rest, CF intake increased cerebral oxygenation, but not BDNF concentrations, and no impact on executive function was detected. This beneficial effect of CF on cerebral oxygenation at rest was overruled by the strong exercise-induced increases in cerebral perfusion and oxygenation.

Haemoglobin variants are inherited disorders of haemoglobin, it is one of the commonest single gene disorder affecting millions of people all over the world, including India. Haemoglobinopathies cause major genetic and public health problems. So, the present study is carried out to find carriers among the healthy individuals to prevent silent transmission of the disorder among the population. Materials and Method: In this study a total of 200 subjects were included amongst the medical students, nurses and nursing students of Silchar Medical College and Hospital for analysis of haemoglobin variants. The study was performed by Horizontal electrophoresis Pherotank by using cellulose acetate membrane and Tris buffer at pH 8.5. Results: Out of 200 subjects studied, 49 subjects had abnormal haemoglobin type. Hb E trait was the most predominant with 31(15.5%) incidence, followed by 9(4.50 %) of HbE/thalassemia, and 6 (3 %) subjects were also found to have HbE disease. It was also seen that thalassemia trait was found in 3 (1.50%) subjects. It was also found that out of total haemoglobin variants 24(48.97%) subjects of HbE trait were anaemic and 7(14.20%) were non-anaemic . 5(10.20%) subjects of HbE disease were anaemic and 1 subject was found to be non- anaemic.

In this paper we present a Time Resolved Near Infrared device for bed-side neuromonitoring of ischemic stroke patients. This system features three wavelengths allowing a better and robust retrieval of the absolute values of oxy and deoxyhaemoglobin. The device has been fully characterized following the guidelines of the MEDPHOT and BIP protocols, developed under NEUROPt project. Time Resolved spectroscopy is a promising technology that can provide reproducible results in terms of absorption and scattering coefficients. This portable and non-invasive system has been proven suitable for operation in clinical settings. Data were collected from a cohort of 47 ischemic stroke patients and, according to their cerebral impairment, compared with normal values obtained from a group of 35 healthy subjects. Significant differences in haemoglobin species concentration and saturation were found between healthy and ischemic stroke patients. In the ischemic area of both recanalized and non-recanalized ischemic stroke patients, deoxy-haemoglobin and total haemoglobin values are higher than in controls, while tissue oxygen saturation values are lower only in recanalized patients. © 2019 SPIE.

In a classical dichotic listening paradigm, besides auditory brain asymmetry, cognitive functions such as attention and conflict resolution play a major role. The aim of this study is to reveal the possible haemodynamic mechanisms of higher attentional performance in prefrontal cortex during dichotic listening test. Twenty-six healthy participants underwent a dichotic listening task in three sessions; non-forced attention, attention focused to right ear, and attention focused to left ear. In each session, haemodynamic activity of prefrontal brain area was recorded using functional near-infrared spectroscopy (fNIRS). Effects of focused attention and performance level of the task on oxy-, deoxy-, and total haemoglobin levels were investigated. Oxy- and total haemoglobin levels in right prefrontal regions during forced-right and forced-left sessions were significantly higher than levels of the non-forced session. This might be an indicator of inhibition and orienting attentional functions of right inferior frontal gyrus. High performers had significantly higher deoxyhaemoglobin levels in the forced-left session compared to the non-forced session, while low performers' deoxyhaemoglobin levels did not differ among these sessions. Observing this difference only in the forced-left session but not in the forced-right session might suggest conflict resolution in top-down and bottom-up processes during the forced-left session for right-handed participants.

Interrelationships between physiological changes (Δ) in erythropoietin (EPO), plasma volume (PV), haemoglobin concentration ([Hb]), and total haemoglobin mass (tHb-mass) were examined in cyclists who trained in different altitudes. Regardless of differences in pattern of changes observed in three training locations, ΔEPO was correlated positively with ΔPV, negatively with Δ[Hb], and trivially with ΔtHb-mass. Δ[Hb] was negatively correlated with ΔPV. In the pooled data the Spearman's rank correlation coefficients were as follows: r = 0.783, P 0.001; r = -0.704, P 0.001; r = 0.136, P 0.05; r = -0.813, P 0.001, respectively. The obtained results have shown that EPO does not only regulate [Hb] by erythropoiesis stimulation but also by PV modulation, which probably aims at keeping proper level of arterial oxygen content for oxygen delivery to tissues.

Eating utensils are usually used from early childhood and thereafter throughout life; therefore, clarification of the effect of use of eating utensils on the brain would be an important topic. Using functional near infrared spectroscopy, we attempted to compare patterns of cortical activation generated during the use of three eating utensils. Twenty healthy normal subjects were recruited. The experimental tasks included transfer of black beans using a fork, wooden chopsticks and stainless steel chopsticks. We measured values of oxyhaemoglobin (HbO) and total haemoglobin (HbT) in five regions of interest: the prefrontal cortex (PFC), frontal eye field (FEF), premotor cortex (PMC), supplementary motor area and primary sensorimotor cortex (SM1). HbO values in all five regions of interest were significantly higher during use of stainless steel chopsticks, compared with use of wooden chopsticks and a fork ( p < 0.05). Regarding the analysis in each region of interest, higher activation was observed in the PFC and FEF during use of wooden chopsticks and stainless steel chopsticks than during use of a fork and wooden chopsticks, respectively, in terms of HbO and HbT ( p < 0.05). HbO value during use of stainless steel chopsticks was higher than that during use of a fork in the PMC and SM1 ( p < 0.05). Use of stainless steel chopsticks involves greater recruitment of neuronal activation in the cerebral cortex, compared with use of wooden chopsticks or a fork.

Summary We aimed at evaluating the effect of isometric muscle contraction on intramuscular water movement at different exercise intensities. Seven men performed 1-min isometric ankle dorsiflexion (20% and 50% maximal voluntary contractions [MVCs]) with a non-magnetic custom-made dynamometer, inside a magnetic resonance (MR) device. Axial diffusion-weighted images were obtained before, during and at 1–20 min (1-min interval) after the exercise to calculate the apparent diffusion coefficient (ADC) of the tibialis anterior. Under the same exercise condition, the concentration change of total haemoglobin (Hb) and myoglobin (Mb) (total Hb/Mb) within the tibialis anterior was assessed by performing near-infrared spectroscopy before, during and after the exercise outside the MR device. The 20% MVC exercise significantly increased the ADC only at 1 min postexercise (P

Near-infrared spectroscopy (NIRS) provides a non-invasive, non-ionizing means to monitor total haemoglobin concentration and oxygen saturation in the living tissue allowing monitoring oxygen sufficiency. Main applications of NIRS are in the study of the transport of the oxygen to the muscles, the cellular metabolism and the cerebral haemodynamics.

[Purpose] The purpose of this study was to investigate whether the occurrence of cardiac-locomotor synchronization (CLS) improves lower leg muscle blood perfusion during walking. [Subjects and Methods] Eleven healthy men were studied while performing two treadmill protocols. The CLS protocol involved subjects walking at the frequency of their heart rate (HR) to induce CLS. The free protocol (reference) involved subjects walking at a self-selected cadence. The treadmill load was identical in the two protocols. Electrocardiographic signals for HR, foot switch signals for step rate and near-infrared spectroscopy (NIRS) signals for total haemoglobin (total Hb) in the lower leg muscles were measured continuously for 10 min after HR reached a steady state. [Results] The mean HR and mean step rate did not differ between the CLS and free protocols. However, total Hb was significantly higher in the CLS protocol than in the free protocol. The rate of increase in total Hb positively correlated with the strength of CLS. [Conclusion] These results suggest that the occurrence of CLS enhances lower leg muscle blood perfusion by increasing the strength of CLS during walking.

Elite rowers are highly endurance trained and present with a large lean body mass (LBM), which is closely related to total haemoglobin mass (tHbmass), a major determinant of blood O2-transport. This study aims to determine the magnitude of tHbmass in elite rowers and its relation to performance parameters that are common in rowing worldwide. 13 rowers (3 lightweight) performed a 2 000 m test to evaluate maximal performance on the rowing ergometer (P2k) and an incremental test to evaluate power output at lactate 2 and 4 mmol/l (N=15). tHbmass was measured by CO-rebreathing. tHbmass amounted to 1 285±123 g (open weight) and 1 059±48 g (lightweight). Coefficients of correlation between tHbmass and power output increased with intensity, being highest for P2k (r=0.80). An increase of 100 g tHbmass is associated with an increase of 24 W in P2k between subjects. The ratio between tHbmass/LBM amounted to approximately 16 g/kg. Absolute tHbmass in elite rowers of open weight class is very high. In relation to body mass or LBM, data is similar to other endurance athletes. The relation between P2k performance and tHbmass is very large. However, it is partly mediated by body composition.

This study aimed to determine whether changes in initial restrictive pressures (IRP, tightness of the cuff before inflation with air) affect tissue oxygenation, lactate production and leg strength before, during and after knee extension exercises. The cuff was positioned on the right thigh, and the IRP of either 40-45 or 60-65 mmHg were applied randomly prior to inflating the cuff to the final restrictive pressure (the pressure reached after inflating the cuff with air). Subjects performed four sets (30, 15, 15 and 15 reps) of isotonic knee extensions with 1-min rest between sets. Tissue oxygenation and blood lactate levels were assessed prior to, during and after exercise, and leg strength was assessed pre- and postexercise. There were significant condition by time interactions (P

A characteristic feature of complex healthy biological systems is the ability to react and adapt to minute changes in the environment. This ‘complexity’ manifests itself in highly irregular patterns of various physiological measurements. Here, we apply Multiscale Entropy (MSE) analysis to assess the complexity of systemic and cerebral near-infrared spectroscopy (NIRS) signals in a cohort of 61 critically ill preterm infants born at median (range) gestational age of 26 (23–31) weeks, before 24 h of life. We further correlate the complexity of these parameters with brain injury and mortality. Lower complexity index (CoI) of oxygenated haemoglobin (HbO2), deoxygenated haemoglobin (Hb) and tissue oxygenation index (TOI) were observed in those infants who developed intraventricular haemorrhage (IVH) compared to those who did not (P = 0.002, P = 0.010 and P = 0.038, respectively). Mean CoI of HbO2, Hb and total haemoglobin index (THI) were lower in those infants who died compared to those who survived (P = 0.012, P = 0.004 and P = 0.003, respectively). CoI-HbO2 was an independent predictor of IVH (P = 0.010). Decreased complexity of brain signals was associated with mortality and brain injury. Measurement of brain signal complexity in preterm infants is feasible and could represent a significant advance in the brain-oriented care.

The use of blood doping is forbidden by the World Anti-Doping Agency. Several practices, such as blood transfusions are used to increase oxygen delivery to muscles and all of them are highly pursued. In this regard, the development of accurate methodologies for detecting these prohibited practices is one of the current aims of the anti-doping control laboratories. Flow cytometry methods are able to detect allogeneic blood transfusions but there is no official methodology available to detect autologous blood transfusions. This paper reviews protocols, including the Athlete Biological Passport, that use indirect markers to detect misuse of blood transfusions, especially autologous blood transfusions. The methods of total haemoglobin mass measurements and the detection of metabolites of blood bags plasticizers in urine are reviewed. The latter seems to be an important step forward because it is a fast screening method and it is based on urine, a fluid widely available for doping control. Other innovative approaches to blood transfusion detection are also mentioned. A combination of the reported methodologies and the implementation of the Athlete Biological Passport is becoming a promising approach.

Standing up shifts blood to dependent parts of the body, and blood vessels in the leg become filled. The orthostatic blood volume accumulation in the small vessels is relatively unknown, although these may contribute significantly. We hypothesized that in healthy humans exposed to the upright posture, volume accumulation in small blood vessels contributes significantly to the total fluid volume accumulated in the legs. Considering that near-infrared spectroscopy (NIRS) tracks postural blood volume changes within the small blood vessels of the lower leg, we evaluated the NIRS-determined changes in oxygenated (Δ[O(2)Hb]), deoxygenated (Δ[HHb]) and total haemoglobin tissue concentration (Δ[tHb]) and in total leg volume by strain-gauge plethysmography during 70 deg head-up tilt (HUT; n = 7). In a second experiment, spatial and temporal reproducibility were evaluated with three NIRS probes applied on two separate days (n = 8). In response to HUT, an initially fast increase in [O(2)Hb] was followed by a gradual decline, while [HHb] increased continuously. The increase in [tHb] during HUT was closely related to the increase in total leg volume (r(2) = 0.95 ± 0.03). After tilt back, [O(2)Hb] declined below and [HHb] remained above baseline, whereas all NIRS signals gradually returned to baseline. Spatial heterogeneity was observed, and for two probes [tHb] was highly correlated between days (r(2) = 0.92 ± 0.09 and 0.91 ± 0.12), but less for the third probe (r(2) = 0.44 ± 0.36). The results suggest a non-linear accumulation of blood volume in the small vessels of the leg, with an initial fast phase followed by a more gradual increase at least partly contributing to the relocation of fluid during orthostatic stress.

We describe innovative methodology for monitoring alterations in bladder oxygenation and haemodynamics in humans using near-infrared spectroscopy (NIRS). Concentrations of the chromophores oxygenated (O2Hb) and deoxygenated (HHb) haemoglobin and their sum (total haemoglobin) differ during bladder contraction in health and disease. A wireless device that incorporates three paired light emitting diodes (wavelengths 760 and 850 nanometers) and silicon photodiode detector collects data transcutaneously (10 Hz) with the emitter/detector over the bladder during spontaneous bladder emptying. Data analysis indicates comparable patterns of change in chromophore concentration in healthy children and adults (positive trend during voiding, predominantly due to elevated O2Hb), but different changes in symptomatic subjects with characteristic chromophore patterns identified for voiding dysfunction due to specific pathophysiologies: bladder outlet obstruction (males), overactive bladder (females), and nonneurogenic dysfunction (children). Comparison with NIRS muscle data suggests altered bladder haemodynamics and/or oxygenation may underlie voiding dysfunction offering new insight into the causal physiology.

Background and Objectives There is no standardized method of measuring the parameters for haemolysis determination of red cell concentrate (RCC). Three haemoglobin quantification methods (automated analyser, Harboe and Drabkin’s) and two methods of haematocrit measurement (automated analyser and microcapillary centrifugation) were evaluated for use with RCC. Materials and Methods Twenty stored RCC were assayed for total haemoglobin, supernatant haemoglobin and haematocrit. Results Drabkin’s and Harboe methods were linear (r2 ≥ 0·995) over 0·015–220 g/l haemoglobin. Overestimation by Drabkin’s increased from 0% at 220 g/l to 137% at 0·015 g/l haemoglobin. Harboe values generally stayed within 6% of expected while haematology analyser values had a maximum 11% underestimation above 10 g/l. Analyser total haemoglobin was significantly lower (202 ± 22 g/l) than Drabkin’s (224 ± 24 g/l) and Harboe (222 ± 22 g/l) values. Haematocrit was greater via the analyser (65·7 ± 5·7%) than with microcapillary centrifugation (59·3 ± 5·7%). Conclusions Harboe and Drabkin’s methods are suitable for measuring total haemoglobin and supernatant haemoglobin in RCC. The analyser gave higher haematocrit values (11% on average) than did microcapillary centrifugation.

We have studied, haemoglobin A(2)' (A(2) prime), a delta chain variant haemoglobin occurring in a small percentage of individuals of African ancestry. In heterozygotes, the percentage of haemoglobin A(2)' was found to be slightly lower then the percentage of haemoglobin A(2), suggesting that the variant delta chain is synthesized at a reduced rate. When quantifying haemoglobin A(2) for the diagnosis of beta thalassaemia heterozygosity, it is essential to add together the A(2) and A(2)' to give 'total haemoglobin A(2)'. However, it not necessary to use a different reference range for total haemoglobin A(2) in A(2)' heterozygotes. When using microcolumn chromatography, A(2)' was found to be measured with A(2). On the high-performance liquid chromatography instrument studied, haemoglobin A(2)' fell in the haemoglobin S window but its retention time differed from that of haemoglobin S.

Ferastral, a new iron-poly (sorbitol-gluconic acid) complex for parenteral use has been given to 22 patients with iron deficiency anaemia. The patients were divided in two groups. Group I received a suboptimal dose of Ferastral iron corresponding to 90% of the iron calculated to normalize the haemoglobin value. Increases in total haemoglobin and also blood losses were measured. The availability of the injected iron for haemoglobin synthesis ranged from 63% to 111%. Group II received an amount of Ferastral-iron calculated to be necessary for normalization of the haemoglobin plus an additional 500 mg of Ferastral-iron. In this group the haemoglobin increase was rapid. In 7 weeks 10 out of 14 patients had reached a normal haemoglobin level.

For a series of clinical healthy subjects of ages 57–71 years, who were considered to fulfil reasonable criteria for representation of the total population, the results are reported of total haemoglobin, blood volume and haemoglobin concentrations, with comparisons between the sexes. Difficulties in calculation of normal values for total haemoglobin and blood volume are discussed. Studies on the relationship between these variables and measures of physical work capacity were made. Results partly deviating from those reported in earlier investigations were obtained. Thus in women no correlation was found between total haemoglobin and blood volume, respectively, and measures of physical work capacity. Possible reasons for this are discussed.

Haemoglobin mass is a main determinant of maximal oxygen uptake. Blood doping aims at increasing this variable. Limits for haematocrit and haemoglobin concentration are used as indicators of blood doping. However, these variables are measures of concentration, do not represent total haemoglobin mass and are altered by vascular volumes shifts. Direct estimation of haemoglobin mass could improve blood tests. It is unknown if physical exercise alters haemoglobin mass. The purpose of this study was to investigate the reaction of haemoglobin mass and other vascular compartments to heavy exercise in athletes. Haemoglobin mass and vascular compartments were evaluated using the optimised CO rebreathing method in 7 elite cyclists during a stage race. Simultaneously, haemoglobin concentration and haematocrit were analysed. Haemoglobin mass (pre-race 958 +/- 123 g, end race 948 +/- 106 g) and red cell volume did not change significantly over the study period, while plasma volume and blood volume tended to increase. Haematocrit (pre-race 44.1 +/- 2.5 %, end race 40.9 +/- 1.59 %) and haemoglobin concentration (pre race 15.8 +/- 0.9 g/dl, end race 14.7 +/- 0.7 g/dl) decreased. During the study, a plasma volume expansion as adaptation to prolonged exercise occurred. Haemoglobin concentration and haematocrit decreased accordingly, whereas haemoglobin mass remained stable. Haemoglobin mass might therefore be a suitable screening tool for blood manipulations.

Background: Globally, sickle cell disease (SCD) is one of the commonest severe monogenic disorders, due to the inheritance of two abnormal haemoglobin (beta globin) genes. SCD can cause severe pain, significant end‐organ damage, pulmonary complications, and premature death. Red blood cell (RBC) transfusions are used to treat complications of SCD, e.g. acute chest syndrome (ACS) (this often involves a single transfusion episode), or they can be part of a regular long‐term transfusion programme to prevent SCD complications. Objectives: To summarize the evidence in Cochrane Reviews of the effectiveness and safety of RBC transfusions versus no transfusion, or restrictive (to increase the total haemoglobin) versus liberal (to decrease the haemoglobin S level below a specified percentage) transfusion, for treating or preventing complications experienced by people with SCD. Methods: We included Cochrane Reviews of randomised or quasi‐randomised controlled trials published in the Cochrane Database of Systematic Reviews, that addressed various SCD complications and had RBC transfusion as an intervention or comparator. We assessed the methodological quality of included reviews according to the AMSTAR quality assessment. Main results: We included 15 Cochrane Reviews, 10 of which had no included studies with an RBC transfusion intervention (five reported RCTs with other interventions; and five contained no studies). Five of the 15 reviews included participants randomised to RBC transfusion, but in one of these reviews only 10 participants were randomised with no usable data. Four reviews (nine trials with 1502 participants) reported data comparing short‐ or long‐term RBC transfusions versus standard care, disease‐modifying agents, a restrictive versus a liberal transfusion strategy and long‐term RBC transfusions versus transfusions to treat complications. All reviews were of high quality according to AMSTAR quality assessment, however, the quality of the included trials was highly variable across outcomes. Trials were downgraded according to GRADE methodology for risk of bias, indirectness (most trials were conducted in children with HbSS), and imprecision (outcomes had wide confidence intervals). In all four reviews and all comparisons there was little or no difference in the risk of death (very low‐quality evidence). There were either no deaths or death was a rare event. Short‐term RBC transfusion versus standard care (one review: two trials, 434 participants, GRADE very low‐ to low‐quality evidence) In people undergoing low‐ to medium‐risk surgery, RBC transfusions may decrease the risk of acute chest syndrome (ACS) in people with African haplotypes compared to standard care (low‐quality evidence), but there was little or no difference in people with the Arabic haplotype (very‐low quality evidence). There was also little or no difference in the risk of other SCD‐related or transfusion‐related complications (very‐low quality evidence). Long‐term RBC transfusion versus standard care (two reviews: three trials, 405 participants, very low‐ to moderate‐quality evidence) In children and adolescents at high risk of stroke (abnormal transcranial doppler (TCD) velocities or silent cerebral infarct (SCI)), long‐term RBC transfusions probably decrease the risk of stroke (moderate‐quality evidence) and may decrease the risk of ACS and painful crisis compared to standard care (low‐quality evidence). Long‐term RBC transfusions may also decrease the risk of SCI in children with abnormal TCD velocities (low‐quality evidence), but there may be little or no difference in the risk of SCI in children with normal TCD velocities and previous SCI (low‐quality evidence). In children and adolescents already receiving long‐term RBC transfusions for preventing stroke, in comparison to standard care, continuing long‐term RBC transfusions may reduce the risk of SCI (low‐quality evidence) but we do not know whether there is a difference in the risk of stroke (very‐low quality evidence). In children with normal TCD velocities and SCI there was little or no difference in the risk of alloimmunisation or transfusion reactions, but RBC transfusions may increase the risk of iron overload (low‐quality evidence). Long‐term RBC transfusion versus RBC transfusion to treat complications (one review: one trial, 72 participants, very low‐ to low‐quality evidence) In pregnant women, long‐term RBC transfusions may decrease the risk of painful crisis compared to transfusion for complications (low‐quality evidence); but there may be little or no difference in the risk of other SCD‐related complications or transfusion reactions (very‐low quality evidence). RBC transfusion versus disease‐modifying agents (hydroxyurea) (two reviews: two trials; 254 participants, very low‐ to low‐quality evidence) For primary prevention of stroke in children, with abnormal TCD and no severe vasculopathy on magnetic resonance imaging/magnetic resonance angiography (MRI/MRA), who have received at least one year of RBC transfusions, we do not know whether there is a difference between RBC transfusion and disease‐modifying agents in the risk of stroke; SCI; ACS; or painful crisis (very‐low quality evidence). There may be little or no difference in the risk of iron overload (low‐quality evidence). Similarly, for secondary prevention of stroke in children and adolescents, we do not know whether there is a difference between these interventions in the risk of stroke; SCI; or ACS (very‐low quality evidence); but hydroxyurea with phlebotomy may increase the risk of painful crisis and global SCD serious adverse events compared to RBC transfusion (low‐quality evidence). There may be little or no difference in the risk of iron overload (low‐quality evidence). Restrictive versus liberal RBC transfusion strategy (one review: one trial; 230 participants, very low‐quality evidence) In people undergoing cholecystectomy, there was little or no difference between strategies in the risk of SCD‐related or transfusion‐related complications (very‐low quality evidence). Authors' conclusions: This overview provides support from two high‐quality Cochrane Reviews for the use of RBC transfusions in preventing stroke in children and adolescents at high risk of stroke (abnormal TCDs or SCI) and evidence that it may decrease the risk of SCI in children with abnormal TCD velocities. In addition RBC transfusions may reduce the risk of ACS and painful crisis in this population. This overview highlights the lack of high‐quality evidence in adults with SCD and the number of reviews that have no evidence for the use of RBC transfusions across a spectrum of SCD complications. Also of concern is the variable and often incomplete reporting of patient‐relevant outcomes in the included trials such as SCD‐related serious adverse events and quality of life.

Background Since 1998, prestorage leucoreduction of all cellular blood components has been made mandatory in France. The French blood service needed to follow the data on the quality of the blood components prepared by blood centres. Material and Methods Quality control (QC) data were submitted to a central data bank by each blood centre. The data were stratified by preparation method for analysis of key performance criteria – residual white blood cell (WBC) and total haemoglobin content. The red blood cell (RBC) preparation processes and the methods for measuring haemoglobin content and residual WBC count were those routinely employed by blood centres. Each year, more than 15 500 RBCs were tested. Results Red blood cells had a mean haemoglobin content between 53·6 and 54·9 g/unit depending on the year (2001 to 2005). The requirement of 40 g/unit was reached for about 99% of units. The haemoglobin content was influenced by the preparation process: 56·8 ± 6·9 vs. 50·6 ± 5·6 g/unit in average for whole blood filtration or RBC filtration, respectively. Apheresis RBCs exhibited a reduced variability (51·8 ± 3·1 g/unit). The median residual WBC count remained low (0·046 to 0·057 × 106 WBCs/unit), and the percentage of RBC units exceeding the 1 × 106 WBCs/unit cut-off ranged from 1·5 to 0·6% depending on the year. A seasonal pattern was observed, with a significant increase (P

Near-infrared spectroscopy combined with partial jugular venous occlusion (JVO) offers promise for determining cerebral venous saturation (CSvO2) in sick preterm infants, but has not been validated in the newborn brain or under conditions of hypoxaemia. We assessed the accuracy of the CSvO2 estimate using cerebral venous oxygen saturation in superior sagittal sinus blood (SSSO2) as the ‘gold standard’. Comparisons were made in seven newborn lambs over a wide range of arterial oxygen saturations (SaO2) of 20% to 100%. Overall, median (range) CSvO2 was 49.8% (10.6% to 88.5%), whereas SSSO2 was 45.5% (4.3% to 76.6%); Bland—Altman analysis revealed a mean difference (CSvO2—SSSO2) of 5.1% and limits of agreement of ±27.4%. The change in cerebral blood volume (Δ CBV) induced by JVO increased with SaO2 ( P 2 with SSSO2 progressively improved with increasing change in total haemoglobin concentration (Δ HbT) induced by JVO. With Bland—Altman analysis repeated for data with Δ HbT >30 μmol cm, the mean difference (CSvO2—SSSO2) decreased to 2.4% with limits of agreement of ±18.8%. We conclude that the accuracy of estimating CSvO2 varies with the Δ CBV induced by JVO. Potential differences of optical properties between the head of the lamb and the human infant suggest that caution be exercised in directly applying these data to the human newborn. Nevertheless, this critical aspect of the JVO technique needs to be taken into consideration in developing an accurate measurement for sick preterm human infants.

Glycated haemoglobin (HbG) concentration is a retrospective measure of mean blood glucose level and is not affected by recent stresses, food ingestion or exercise. HbG has been determined in various wild and domestic animals such as kestrels, mankhor, mouflon, aoudad, deer, goat, sheep, dog, camel and horse. But there is no information regarding HbG in ostrich and its relation to blood glucose. The purposes of this study were to determine the normal values of HbG in ostriches and to investigate its relation to fasting plasma glucose. Blood samples were collected from jugular veins of 30 clinically healthy ostriches after 12 h of fasting. After separation and washing of red blood cells, haemolysate was prepared and subjected to weak cation exchange chromatography for determination of HbG. Glucose was measured in plasma samples. Fasting plasma glucose and HbG were 11.23 ± 0.80 mmol/l and 1.20 ± 0.2% of total haemoglobin, respectively. It was shown that HbG percent and fasting plasma glucose were correlated (P

A routine method to determine total haemoglobin mass (tHb) in clinical practice and sports medicine is non-existent. Radioactive tracers or other dilution procedures like the common CO-rebreathing method (Proc(com)) are impractical, the latter in particular because of the relatively long time of respiration. According to the multicompartment model of Bruce and Bruce (J Appl Physiol 95:1235-1247, 2003) the respiration time can be considerably reduced by inhaling a CO-bolus instead of the commonly used gas mixture. The aim of this study was to evaluate this theoretical concept in practice. The kinetics of the HbCO formation were compared in arterialised blood sampled from an hyperaemic earlobe after inhaling a CO-bolus (Proc(new)) for 2 min and a CO-O(2) mixture (Proc(com)) for approximately 10 min. The reliability of Proc(new) was checked in three consecutive tests, and phlebotomy was used to determine the validity. VO(2max) was determined with and without previous application of Proc(new) and the half-time of HbCO was registered also in arterialised blood after resting quietly and after the VO(2max) test. Proc(new) yielded virtual identical tHb values compared to Proc(com) when HbCO determined 5 min after starting CO-rebreathing was used for calculation. The typical error of Proc(new) was 1.7%, corresponding to a limit of agreement (95%) of 3.3%. The loss of 95 g (19) haemoglobin was detected with an accuracy of 9 g (12). After application of Proc(new) VO(2max) was reduced by 3.0% (3.7) (P=0.022) and half-time was lowered from 132 min (77) to 89 min (23) after the VO(2max) test. Inhaling a CO-bolus markedly simplifies the CO-rebreathing method without reducing validity and reliability and can be used for routine determination of tHb for various indications.

The aim of the study was to assess changes in myocardial oxygenation in patients with ischaemic heart disease during surgical revascularisation. In 20 patients, regional oxygen saturation, oxyhaemoglobin and total haemoglobin concentrations were examined by near-infrared spectroscopy in the myocardium and in a non-ischaemic skeletal muscle, which served as a control. Pre-revascularisation values of all spectroscopy parameters were 40–50% lower in the myocardium than in the control. After successful revascularisation 02 saturation, oxy-, and total haemoglobin in the myocardium increased by 20, 29. and 18%, respectively (P2 saturation. In the control muscle and in a patient with incomplete revascularisation the regional 02 saturation decreased. This preliminary report indicates potential value of the near infrared spectroscopy in an immediate assessment of postoperative changes in myocardial perfusion and oxygenation.

A total of 1,647 cord blood samples (618 of scheduled tribes, 487 of scheduled castes and 542 of general castes) of newborns from the Banswara, Bhilwara, Chittorgarh, Dungarpur, Sirohi and Udaipur districts of the Aravali hilly region of Rajasthan were investigated electrophoretically for evidence of Hb-Bart's (alpha-thalassaemia). Hb-Bart's was encountered in 31 (1.88%) neonates constituting 1.8 to 12.6% of their total haemoglobin. Of these, 24 (1.46%) were of alpha-thalassaemia 1 and 7 (0.42%) of alpha-thalassaemia 2. The incidence of alpha-thalassaemia genes varied from 3.07% in the scheduled tribes, 1.43% in the scheduled castes to 0.77% in the general castes populations giving an overall incidence of 1.88%. Except Hb-Bart's allele, no other mutant haemoglobins were observed.

The underlying mechanisms of altitude training are still a matter of controversial discussion but erythropoietic adaptations with an increase of total haemoglobin mass (tHb) have been shown in several studies, partly depending on an adequate hypoxic dose. The aim of this retrospective study was to investigate if a 3 weeks sojourn at moderate altitude (1816 m) with conventional training sessions (live and train at moderate altitude), especially under real and uncontrolled conditions, results in an increased tHb. tHb was measured in seven male cyclists competing at elite level (German national cycling team, U23 category) prior to the ascent to altitude and immediately after descent to sea-level. The athletes completed a 21 days altitude training camp living at 1816 m and training at 1800–2400 m during the competitive season. No significant difference was found in tHb after the altitude sojourn (prior 927 ± 109 g vs. 951 ± 113 g post, 95% CI −13–61 g). Additionally, the analysis of red cell volume, plasma volume and blood volume or haemoglobin concentration [Hb] as well as haematocrit (Hct) did not reveal any significant changes. The data supports the theory that an adequate hypoxic dose is required for adaptations of the erythropoietic system with an increase of tHb and a threshold of approximately 2100–2500 m has to be exceeded.

The purpose of this study was to document the effect of 23 days of "live high, train low" on the haemoglobin mass of endurance athletes. Thirteen male subjects from either cycling, triathlon or cross-country skiing backgrounds participated in the study. Six subjects (HIGH) spent 8-10 h per night in a "nitrogen house" at a simulated altitude of 3000 m in normobaric hypoxia, whilst control subjects slept at near sea level (CONTROL, n = 7). Athletes logged their daily training sessions, which were conducted at 600 m. Total haemoglobin mass (as measured using the CO-rebreathing technique) did not change when measured before (D1 or D2) and after (D28) 23 nights of hypoxic exposure [HIGH 990 (127) vs 972 (97) g and CONTROL 1042 (133) vs 1033 (138) g, before and after simulated altitude exposure, respectively]. Nor was there any difference in the substantial array of reticulocyte parameters measured using automated flow cytometry prior to commencing the study (D1), after 6 (D10) and 15 (D19) nights of simulated altitude, or 1 day after leaving the nitrogen house (D28) when HIGH and CONTROL groups were compared. We conclude that red blood cell production is not stimulated in male endurance athletes who spend 23 nights at a simulated altitude of 3000 m.

The total bilirubin, total haemoglobin, and haemoglobin fractions were studied in the cord blood and in the heel puncture blood at one, three, and seven days, and at three or four weeks after birth, in 32 normal newborns. No relationship was found to exist between the rate of destruction of the total haemoglobin, or of its most refractory component f3 and the degree of bilirubinaemia. The proportion of this f3, component did not always undergo progressive steady destruction, nor did it seem to be selectively destroyed in the neonatal period and it would not appear to play any special role in the production of neonatal jaundice.

In the 36th week of gestation intrauterine death of both twins occurred in a 31-year old primigravida. The examination of the C- and the D-antigen of the mother's blood (result of previous testing: AB Rhesus negative) immediately before delivery showed a mixed field agglutination which pointed to a fetomaternal macrotransfusion. Fetal haemoglobin in the mother's circulation was 7.8% of her total haemoglobin, so that a fetomaternal haemorrhage of about 440 ml whole blood had to be suspected. For Rhesus-prophylaxis 17 standard doses of anti-D-immunoglobulin were administered intramuscularly distributed over 4 days. No adverse effects were seen; fetal haemoglobin dropped to 2.0% 5 days and to 0.1% 15 days after the beginning of the treatment. A control examination after 9 months showed no signs of a Rhesus-(D)-sensitisation of the patient.

It remains unclear by which mechanism 'live high-train low' (LHTL) altitude training increases exercise performance. Haematological and skeletal muscle adaptations have both been proposed. To test the hypotheses that (i) LHTL improves maximal oxygen uptake (VO(2)max) and (ii) this improvement is related to hypoxia-induced increases in total haemoglobin mass (Hb(mass)) and not to improved maximal oxidative capacity of skeletal muscle, we determined VO(2)max before LHTL and after LHTL, before and after the altitude-induced increases in Hb(mass) (measured by carbon-monoxide rebreathing) had been abolished by isovolumic haemodilution. We obtained skeletal muscle biopsies to quantify mitochondrial oxidative capacity and efficiency. Sixteen endurance-trained athletes were assigned (double-blinded, placebo controlled) to ≥16 h/day over 4 weeks to normoxia (placebo, n=6) or normobaric hypoxia equivalent to 3000 m altitude (LHTL, n=10). Four-week LHTL did not increase VO(2)max, irrespective of treatment (LHTL: 1.5%; placebo: 2.0%). Hb(mass) was slightly increased (4.6%) in 5 (of 10) LHTL subjects but this was not accompanied by a concurrent increase in VO(2)max. In the subjects demonstrating an increase in Hb(mass), isovolumic haemodilution elicited a 5.8% decrease in VO(2)max. Cycling efficiency was altered neither with time nor by LHTL. Neither maximal capacity of oxidative phosphorylation nor mitochondrial efficiency was modified by time or LHTL. The present results suggest that LHTL has no positive effect on VO(2)max in endurance-trained athletes because (i) muscle maximal oxidative capacity is not improved following LHTL and (ii) erythrocyte volume expansion after LHTL, if any, is too small to alter O(2) transport.

Blood donation volumes less than 350 ml are classified as 'undercollected' at the NSW Red Cross Blood Transfusion Service (BTS) and are discarded. This study evaluated the in vitro characteristics during storage of both undercollected units and units of acceptable volume. Thirty-two units of whole blood were each collected into 63 ml of CP2D-A, with blood volumes ranging from 180 to 456 ml. The units were stored between 4 and 6 degrees C for 35 days and in vitro measurements were performed weekly. Biochemical parameters measured included ATP, extracellular pH, total haemoglobin, haematocrit, mean cell volume, plasma sodium and potassium, plasma haemoglobin, 2,3-DPG and lactate levels. All parameters were within the BTS acceptable quality control limits for whole blood. Thus, it appears feasible to transfuse undercollected units with volumes between 180 and 350 ml. However, routine transfusion of undercollected homologous units is undesirable. In contrast, it may be preferable to transfuse an autologous unit, even if it was undercollected. The performance of in vivo survival studies would provide confirmatory data on this proposition.

Scoparia dulcis L. commonly known as 'Sweet Broomweed' is widely used in Indian folk medicine for the treatment of diabetes mellitus. Oral administration of 0.15, 0.30 and 0.45 g/kg body weight of the aqueous extract of the Scoparia dulcis leaves (SLEt) for 45 days resulted in a significant reduction in blood glucose, glycosylated haemoglobin and an increase in total haemoglobin but in the case of 0.45 g/kg body weight the effect was highly significant. The aqueous extract also prevented a decrease in the body weight. An oral glucose tolerance test was also performed in experimental diabetic rats, in which there was a significant improvement in glucose tolerance in animals treated with SLEt and the effect was comparable to that of glibenclamide.

We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.

The Athlete Blood Passport is the most recent tool adopted by anti-doping authorities to detect athletes using performance-enhancing drugs such as recombinant human erythropoietin (rhEPO). This strategy relies on detecting abnormal variations in haematological variables caused by doping, against a background of biological and analytical variability. Ten subjects were given twice weekly intravenous injections of rhEPO for up to 12 weeks. Full blood counts were measured using a Sysmex XE-2100 automated haematology analyser, and total haemoglobin mass via a carbon monoxide rebreathing test. The sensitivity of the passport to flag abnormal deviations in blood values was evaluated using dedicated Athlete Blood Passport software. Our treatment regimen elicited a 10% increase in total haemoglobin mass equivalent to approximately two bags of reinfused blood. The passport software did not flag any subjects as being suspicious of doping whilst they were receiving rhEPO. We conclude that it is possible for athletes to use rhEPO without eliciting abnormal changes in the blood variables currently monitored by the Athlete Blood Passport.

To evaluate differences in total haemoglobin mass (tHb mass) and in red blood cell profile between elite endurance-trained (END) and non-endurance-trained (nEND) male and female adolescent athletes, tHb mass (CO rebreathing) and specific variables of red blood cell profile (haemoglobin concentration, haematocrit, erythrocyte indices) were determined in 59 elite junior athletes (29 END, 30 nEND). We hypothesized that at the age of 15-17 years, regular endurance training might induce a significant increase in tHb mass and changes in red blood cell profile. Therefore, all parameters were again determined after 6, 12 and 18 months in a subset of 27 subjects (17 END, 10 nEND). In END, tHb mass related to body weight was ~15% greater than in nEND (11.2 ± 1.6 vs. 9.7 ± 1.3 g kg(-1), P 0.001), whereas no significant differences were observed for the red blood cell profile. In both groups, tHb mass related to body weight and the variables of red blood cell profile had not changed significantly after 6, 12 and 18 months of regular training. In conclusion, in elite junior athletes, differences in tHb mass between END and nEND were similar, however, smaller compared with previously in adult athletes reported values. At the age of 15-17 years, 18 months of regular training did not induce significant changes in tHb mass beyond alterations explained by physical growth and also variables of red blood cell profile did not change significantly.

The aim of the present study was to assess the potential effects of intermittent Universal Mobile Telecommunications System electromagnetic fields (UMTS-EMF) on blood circulation in the human head (auditory region) using near-infrared spectroscopy (NIRS) on two different timescales: short-term (effects occurring within 80 s) and medium-term (effects occurring within 80 s to 30 min). For the first time, we measured potential immediate effects of UMTS-EMF in real-time without any interference during exposure. Three different exposures (sham, 0.18 W/kg, and 1.8 W/kg) were applied in a controlled, randomized, crossover, and double-blind paradigm on 16 healthy volunteers. In addition to oxy-, deoxy-, and total haemoglobin concentrations ([O(2) Hb], [HHb], and [tHb], respectively), the heart rate (HR), subjective well-being, tiredness, and counting speed were recorded. During exposure to 0.18 W/kg, we found a significant short-term increase in Δ[O(2) Hb] and Δ[tHb], which is small (≈17%) compared to a functional brain activation. A significant decrease in the medium-term response of Δ[HHb] at 0.18 and 1.8 W/kg exposures was detected, which is in the range of physiological fluctuations. The medium-term ΔHR was significantly higher (+1.84 bpm) at 1.8 W/kg than for sham exposure. The other parameters showed no significant effects. Our results suggest that intermittent exposure to UMTS-EMF has small short- and medium-term effects on cerebral blood circulation and HR.

The purpose of the study was to reveal erythropoietin (epo) doping. It was recently suggested that the assessment of total haemoglobin mass (tHb) by means of the carbon monoxide re-breathing technique should be implemented in anti-doping work. Since epo may increase the haemoglobin concentration [Hb] simply by reducing plasma volume we injected eight human subjects with epo for 15 weeks and directly tested the feasibility hereof. Epo treatment increased [Hb] in all subjects at all time points (range 3.8-18.8%). In approximately half the subjects this was mainly the consequence of an increased tHb, but in the remaining subjects the change was the result of a decrease in the plasma volume. After the initial epo "boosting" period the assessment of tHb could not detect epo injections in 50% of the subjects in the remaining "maintenance" period. In our opinion the variability observed over time when assessing tHb is not justifiable in an anti-doping setting.

Determination of total haemoglobin mass (Hbmass) via carbon monoxide (CO) depends critically on repeatable measurement of percent carboxyhaemoglobin (%HbCO) in blood with a hemoximeter. The main aim of this study was to determine, for an OSM3 hemoximeter, the number of replicate measures as well as the theoretical change in percent carboxyhaemoglobin required to yield a random error of analysis (Analyser Error) of ≤1%. Before and after inhalation of CO, nine participants provided a total of 576 blood samples that were each analysed five times for percent carboxyhaemoglobin on one of three OSM3 hemoximeters; with approximately one-third of blood samples analysed on each OSM3. The Analyser Error was calculated for the first two (duplicate), first three (triplicate) and first four (quadruplicate) measures on each OSM3, as well as for all five measures (quintuplicates). Two methods of CO-rebreathing, a 2-min and 10-min procedure, were evaluated for Analyser Error. For duplicate analyses of blood, the Analyser Error for the 2-min method was 3.7, 4.0 and 5.0% for the three OSM3s when the percent carboxyhaemoglobin increased by two above resting values. With quintuplicate analyses of blood, the corresponding errors reduced to .8, .9 and 1.0% for the 2-min method when the percent carboxyhaemoglobin increased by 5.5 above resting values. In summary, to minimise the Analyser Error to ∼≤1% on an OSM3 hemoximeter, researchers should make ≥5 replicates of percent carboxyhaemoglobin and the volume of CO administered should be sufficient increase percent carboxyhaemoglobin by ≥5.5 above baseline levels.

Erythrocyte methaemoglobin reductase deficiency is described in a toy Alaskan Eskimo dog, a miniature poodle dog and a cocker/poodle cross dog. Blood methaemoglobin contents ranged from 19% to 36% of total haemoglobin, with methaemoglobin reductase values between 13% and 33% of normal. There appeared to be a negative linear correlation between erythrocyte methaemoglobin content and methaemoglobin reductase activity. A single intravenous injection of methylene blue (1 mg/kg body weight) resulted in a dramatic decrease in methaemoglobin content within 1 hour when given to two of the deficient dogs in the present study. Following the disappearance of methylene blue from blood, methaemoglobin content increased linearly at 3.2% and 2.5% per day in these dogs, suggesting that about 3.0% of erythrocyte haemoglobin is normally oxidised to methaemoglobin each day in dogs, as has been estimated in humans. Oral riboflavin therapy was not effective in reducing blood methaemoglobin content in deficient dogs.