Back to Search Start Over

Resuscitation with washed aged packed red blood cell units decreases the proinflammatory response in mice after hemorrhage.

Authors :
Belizaire RM
Makley AT
Campion EM
Sonnier DI
Goodman MD
Dorlac WC
Friend LA
Lentsch AB
Pritts TA
Source :
The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2012 Aug; Vol. 73 (2 Suppl 1), pp. S128-33.
Publication Year :
2012

Abstract

Background: Resuscitation with blood products instead of crystalloid in the treatment of hemorrhagic shock has been associated with improved outcomes in trauma patients requiring massive transfusions and transfusion of fresh products results in reduced morbidity and mortality compared with aged blood. Processes to eliminate harmful components of aged blood are under investigation. We hypothesized that washing blood would reduce levels of proinflammatory mediators in stored units, and resuscitation with washed units would attenuate the proinflammatory response in mice after hemorrhagic shock.<br />Methods: Mice underwent pressure-controlled hemorrhage and resuscitation with fresh packed red blood cells (pRBCs) or 15-day-old washed or unwashed pRBCs. Cytokine concentrations in donor samples and recipient serum were measured. In addition, cytokine concentrations were measured in 15-day-old units that underwent three interval washes versus one poststorage wash.<br />Results: Blood stored for 15 days demonstrated increased levels of interleukin 1α, keratinocyte chemoattractant, macrophage inflammatory protein 1α, and macrophage inflammatory protein 2 compared with fresh units. Washing 15-day-old pRBCs reduced concentrations of these cytokines. Cytokine levels in stored units that underwent multiple washes versus a single wash were not different. Mice resuscitated with 15-day-old unwashed pRBCs had increased levels of serum cytokines compared with mice resuscitated with fresh and 15-day-old washed pRBCs.<br />Conclusion: Aged pRBC units have elevated levels of proinflammatory cytokines compared with fresh units, and washing aged units after storage reduces cytokine concentrations. Resuscitation with washed units blunts the proinflammatory response in mice after hemorrhage. Washing aged pRBCs may improve the safety profile of aged units and may result in improved outcomes in subjects after hemorrhagic shock and resuscitation.

Details

Language :
English
ISSN :
2163-0763
Volume :
73
Issue :
2 Suppl 1
Database :
MEDLINE
Journal :
The journal of trauma and acute care surgery
Publication Type :
Academic Journal
Accession number :
22847082
Full Text :
https://doi.org/10.1097/TA.0b013e3182606301