Acute and Critical Care

Original Article

Cardiology
A comparative study of stored arterial versus venous blood collected using the acute normovolemic hemodilution method in coronary artery bypass grafting patients in Iran: Mojtaba Mansouri, Alireza Yazdani, Gholamreza Masoumi, Mohsen Mirmohammadsadeghi, Amir Mirmohammadsadeghi; Acute Crit Care. 2023;38(3):353-361. Published online June 15, 2023; DOI: https://doi.org/10.4266/acc.2022.01382

Abstract PDF: Background
In the present study, arterial and venous blood was collected from patients who were candidates for elective coronary artery bypass grafting (CABG); the blood was stored for 28 days and cellular, biomechanical, and hematological changes in blood were compared to determine whether stored arterial blood is superior to stored venous blood.
Methods
The present follow-up comparative study included 60 patients >18 years of age, with hemoglobin >14 mg/dl and ejection fraction >40% who were candidates for CABG. After induction of anesthesia, 250 ml of arterial or venous blood was drawn from patients (arterial blood group and venous blood group). Laboratory blood samples were taken at specified times from the collected blood and re-injected into the patients after CABG.
Results
Significant differences were observed in pH, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), bicarbonate (HCO3), and glucose values at several time points between the groups. Other parameters such as urea and creatinine did not show any significant differences between the groups.
Conclusions
Twenty-eight days of storage can have a negative effect on some of the cellular, biochemical, and hematological components of arterial and venous blood; however, the quality of stored arterial blood and venous blood does not differ significantly.

Case Reports

The Effect of Hemodilution Treatment for Patient with Hemorrhagic Cerebral Venous Thrombosis due to Iron Deficiency Anemia: A Case Report: Mi Hye Lim, Sun Young Oh, Young Hyun Kim, Byoung Soo Shin; Korean J Crit Care Med. 2009;24(1):47-50.; DOI: https://doi.org/10.4266/kjccm.2009.24.1.47

Abstract PDF: Cerebral venous sinus thrombosis (CVT) is a rare disease that's associated with a wide variety of clinical signs and symptoms, and CVT is a potentially lethal condition. Iron deficiency anemia (IDA) as the cause of an adult case of CVT is very rare. We report here on a patient with CVT with intracerebral hemorrhage that was caused by IDA, and the patient was treated with hemodilution. We suggest that hemodilution should be considered as another therapeutic option for CVT with cerebral hemorrhage in a patient suffering with IDA.

Anesthetic Experience of Hemorrhagic Shock Patient with Rh-, AB Blood Type without Blood Transfusion: Sang Kyi Lee, Woo Sun Kim; Korean J Crit Care Med. 1997;12(2):173-176.

Abstract PDF: Blood loss is usually replaced with crystalloid or colloid solutions until a predetermined minimal hematocrit is reached. But in severe blood loss, blood transfusion is indicated for maintenance of oxygen-carrying capacity, coagulation factors and intravascular volume. Jehovah's witness patients refuse blood transfusion, but some patients with rare blood type may even not have the chance of blood transfusion. Commonly utilized and effective alternatives to blood transfusion are acute hemodilution, autotransfusion and other blood salvage techniques. We report a case of successful anesthetic management in patient of hemorrhagic shock with rare blood type (Rh-, AB type) without blood trasfusion.

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