Transfusion of Red Blood Cells under Shock Conditions in the Rat Microvasculature.
Bibliographic record
Abstract
Abstract Background RBC transfusion is the mainstay of therapy for resuscitation of patients with hemorrhagic shock. Ex-vivo storage of RBCs for transfusions is associated with a storage lesion which decreases erythrocyte deformability and increases their adhesiveness to vascular endothelium. This may impair microcirculatory flow with deleterious effects on oxygen delivery post-transfusion. The objective of this study was to determine whether transfused stored rat blood impairs the microcirculation following resuscitation from hemorrhagic shock Methods Donor Sprague Dawley rat RBCs were collected and stored in CPDA-1 under standard blood bank conditions. RBCs were labelled with FITC (fluorescein isothiocyanate) 24 hours before the experiment. RBCs stored for less than 24 hours (fresh) RBCs (n=3) were compared to RBCs stored for 7 days (n=3). To induce shock, forty percent of blood volume was removed from male Sprague Dawley rats. Animals were then resuscitated by injecting 1.5mL of labelled packed RBCs and sufficient saline to restore blood volume via arterial line. The number of adherent labelled RBCs in the extensor digitorum longus muscle (EDL) was detected using intravital video microscopy (20X magnification). RBC velocity, capillary diameters, capillary Hct (hematocrit), arterial Hct, and lactate data was collected at three time points (baseline, shock and resuscitation). Results Lactate levels increased significantly during shock in both the fresh and stored groups. Arterial Hct decreased in shock and was restored to baseline levels with resuscitation. The stored group had an increased number of stopped cells in the microcirculation compared to their fresh counterparts (p=0.004). There was no statistical significant difference in capillary diameters between groups or time points. Both groups showed an increase in RBC velocity from baseline to resuscitation (stored group doubled, fresh group tripled). Capillary Hct did not change in the fresh group but doubled in the old group from baseline to resuscitation. Conclusion In our shock model, transfusion of stored RBCs resulted in an increased number of stopped cells and lower RBC velocity in capillaries as compared to fresh RBCs. Stored RBCs also had an increased capillary Hct from baseline to resuscitation and a diminished hyperemic response as compared to fresh RBCs. We conclude that stored RBCs following transfusion behave differently than native or fresh transfused cells in the microcirculation. Further studies are needed to determine the impact of these microcirculatory changes on oxygen availability in transfusion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".