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Banked Blood May Not Be As Effective As Hoped
URSpider alerts us to two separate research reports published in the Proceedings of the National Academy of Sciences pointing to the rapid breakdown of nitric oxide in donated blood as a reason why such blood loses its ability to transfer oxygen, and is sometime implicated in problems such as strokes and heart attacks. Nitric oxide depletion is significant after 3 hours of storage; yet current guidelines allow for storing donated blood for up to 42 days. The article notes: "Several of the researchers, including Stamler, have consulting and/or equity relationships with Nitrox/N30, a company developing nitric oxide based therapies."
Let me weigh up the situation here:
Die due to running out of blood.
Survive because someone donated blood.
I realise that the length of time is a factor and you want the freshest possible, but beggars can't be choosers.
liqbase
just keep these handy in the operating rooms.
It's hard to believe that's how Micronians are made. Why don't we see it right now by having you both kiss one another?
Damn I just needed to add blood to the air intake!
As point out in the article, the study was funded by a company that makes a "drug" to fix this!
Never trust a man wearing a coat and tie!
Free whippets for all blood donors! WHOOOOOOOOOOOOOO
Perhaps the blood is not as efficient as it could be in transferring oxygen, but I would think that it is still pretty damn useful.
We have always been at war with Eurasia!
The article is referring to Nitric Oxide - NO -- not Nitrous Oxide - N2O
1. This is a study with participants highly linked to a firm that makes money off of adding NO to blood products. They have financial and other incentives to find a "lack" of NO in stored blood.
2. As with any study, an independent study should be done to see if this is verifiable and repeatable. This should be done by a lab that is not financially or otherwise linked to the NO additive firm aforementioned.
3. The other thing to look at is method of storage, temperature, and other conditions - did they conform to current standards, did they vary these elements, and was this independently audited?
-- Tigger warning: This post may contain tiggers! --
That's one poor summary.
It's well known that packed red blood cells or whole blood is not as effective as fresh blood at transporting hemoglobin. This is because of several factors, notably shifts in 2,3-BPG, ATP, ADP during storage as well as partially due to the calcium citrate used to prevent clotting of the stored blood.
While it isn't ideal, our current method is by far the safest way to give blood, simply because you cannot screen blood for deadly pathogens in the time it takes for blood to start to degrade. While many people have researched ways to shift the binding characteristics of stored blood back to fresh blood, and with some success on manipulation of hemoglobin's oxygen binding curves, overall the clinical effect for patients has been minimal.
The nitrous-oxide pathway, to my knowledge, has not been tried yet, but I'd hate to have my blood pre-mixed with a drug that would kill a percentage of the patients who are candidates for blood transfusion. When someone is exsanguinating, you want to INCREASE their blood pressure, not decrease it.
On the other hand, in ischemic disease you do want to give nitro, in certain situations, but preferably not pre-mixed with the blood, and we already do this, just not in strokes, yet.
One of my mom's uncles has the same blood type as her. As a girl my mom needed to have lots of surgery. When she needed blood, my uncle would donate blood specifically for my mom. No need to worry about oxygen levels!
There was a similar problem with fluorocarbon based blood substitutes in that they also increased the risk of stroke. perhaps this problem with nitrogen monoxide is the cause of the higher risk of stroke
Sigs are too short to say anything truly profound so read the above post instead.
Well, not having read the study I can not comment on its significance; however, there is far more to blood transfusion dangers than NO depletion.
Lets get to some significant points: NO is produced locally at the tissues that need it.
RBC fragility is likely more significant than the effects of one vasodilator
Multiple unnecessary (or necessary) transfusions may lead to iron overload similar to that found in people with hemachromatosis
TRALI
I am not attacking their work, but there are so many other reasons to be vary of transfusions - the significance of this one seems like it would be minimal, but I do applaud their work in trying to minimize complications of transfusion.
When all else fails, try.
Now this "news report" would have us believe that there's been a problem all this time, and either nobody did any research on it, or if they did they were total numbskulls to not see the connection between lowered oxygen efficacy and the lowering of chemical X.
Smells a teeensy bit fishy.
Successful blood transfusion has only been around for ~100 years. Before that there were attempts with usually deadly results and the practice to let your blood run out was practiced on a regular basis.
Even now, blood transfusions are only used by doctors in the most critical situation and yes, storage and transfer of blood as well as the necessary screenings make it very difficult to get a 1) cheap and 2) reliable source of blood.
Some doctors even don't use blood transfusions at all (there are even some hospitals that don't give any blood for any reason) and use substitutes like volume expanders or oxygen carriers to get what the body needs (either a larger volume of blood or more carriers so a subject doesn't asphyxiate) or they use only parts of the blood that are deemed necessary (for example to clot your blood faster) and that are more safe than blood.
Blood is considered an organ, with transfusions you get issues like rejection just like you get (often) with liver transplants and giving somebody a large amount of foreign blood could also result in shock or death.
Custom electronics and digital signage for your business: www.evcircuits.com
You are correct. We don't know one tenth of one percent about anything. That means we should just ignore everything that we do know until we know everything.
The slashdot article mentions Nitrous Oxide (N20 aka Dinitrogen Monoxide), but the original article talks about Nitric Oxide (NO = Nitrogen Monoxide). The wikipedia page says that the two should not be confused. The former is an anesthetic, the latter is a "toxic air pollutant". Alas, this means that huffing whippets before giving blood isn't going to make it stay fresh longer.
Oh, come on, man. Do you have any ideas how many lives have been saved from blood transfusions? They are VERY effective. This article is pointing out that they could be MORE effective.
Taking this article to mean that all science is bullshit is a pretty fucking big leap. I guess what I'm saying is, you're an idiot.
Also, it doesn't taste as good.
When my wife lost 2/3 of the blood in her body, those extra pints they put in her didn't do anything at all. Well, other than keep her alive. Sheesh, to think that's *all* it did. Crappy, old blood.
Oh, you're not stuck, you're just unable to let go of the onion rings.
I think you mean pissing in the Category 4 hurricane.
You have a point though, science in the macro is never as well-defined as science in the micro.
I see they're coming out of the woodwork and posting on /. These type of stories are music to their ears. Former JWs know what I'm talking about.
I agree with the beginning of your post, but not the conclusion. Yes, we've been messing with blood transfusions for centuries, but in that time we've learned about blood types (thus explaining the mysterious deaths of a large portion of those receiving transfusions), learned to test for diseases, store and maintain blood supplies, and have the donation down to a system where I can do it at lunch and go back to work. Now, we may even be able to do a hybrid of synthetic/natural blood that's more effective than the stored blood would be otherwise; that's quite a feat.
Your concluding that scientists are just pissing in the wind is like concluding that car manufacturers are just pissing in the wind because of the recent invention of heated seats.
where we can store extra humans, or perhaps clones to insure proper blood type and rely on their parts when we real people need to be repaired.
Ave Molech Setting
"This is an important observation and it needs to be followed up," said Dr. Louis Katz, a past president of America's Blood Centers, which provides about half the nation's blood."
Not exactly. From America's Blood Center's website profile:
"Founded in 1962, America's Blood Centers (ABC) is North America's largest network of non-profit, community blood centers."
Note the word "network". They are a trade organization - "America's Blood Centers" doesn't "provide" blood products - their members do.
The largest "provider" of blood and blood products is the American Red Cross, with about 40% of the market (cue "ARC is evil" comments". After that is United Blood Services, with about 10%, I think. Then it's a whole bunch of regional blood banks, each with a very small market share.
Regardless of who said what to whom, there is never enough blood in the system for more than a few days.
GIVE BLOOD!
"As God is my witness, I thought turkeys could fly." A. Carlson
Platelet storage time: 5 days max.
They need your platlets. Give the ABC apheresis way. Thank you.
It works great, but just not as well as your own blood. When administered, you will see a persons heart rate decrease if they are tachycardic(fast heart rate) from a low hemoglobin (blood count). The blood definitely does work, but probably only 60-80% as effective as regular blood.
..........FULL STOP.
-1, Uncomfortable Fact.
that was in 1983 you tard, before they understood how hiv was transmitted.
If you mod me down, I will become more powerful than you can imagine....
It's nothing but crumpled porno and Ayn Rand.
To sell blood? I fully support giving blood, but what's the point if it's just going to be sold at a profit? I'm not in the habit of giving charitable donations to corporations.
Does banked blood last longer than a DVD-backup?
I'm sure your local blood bank would say exactly the same thing regardless of what type you were asking after.
Nitric Oxide (NO, not NO2 or N2O) is a small molecule that is used by the body as a messenger that causes blood vessels to dilate. It is a messenger that is naturally produced by the body.
/. (not only medical geeks, but also people who watch medical shows like ER and House. Not Grey's Anatomy) know that, in those circumstance, dilating the blood vessels by adding NO is the last thing you want to do, because the dilatation will drop the blood pressure again. In fact what you give those people is adrenaline, which *contracts* the vessels, and cause the pressure the rise back to the normal. But as said before, contraction increase the risk of not enough blood flow in the coronary arteries, thus risk of stroke.
:
In natural circumstance, for exemple, it is produced during effort to divert blood to region where it is needed (because the adrenaline has a global effect of closing the blood vessels).
In medicine, products that create NO like Nitroglycerin are used to dilate vessels and increase blood flow to the heart in case of angor (not enough blood in the heart muscle because of cholestrerol-clogged arteries).
Sildenafil (Viagra) is an inhibitor which stops the destruction of NO, thus maintaining enough level of NO, so the vessels are dilate and there's enough blood flow to fill the penis and provide erection.
Yes, if there's not enough NO, a stroke may appear. That's why Nitro-glycerine is given to avoid it.
Yes, transfused blood is more dense than other substance that can be injected to compsensate blood loss (other substance = Ringer solution = physiological serum = basically isotonic sterile salty water with some additional sugar thrown in). And this increased viscosity may increase the risk of stroke.
Now, just concentrate for a moment : to whom are you going to transfuse blood / perfuse physiological serum ?
People who lost a lot of liquid (bleeding wounds, burns, etc.).
Why ?
Because their blood pressure is dropping and there is a risk of shock (= schematically, not enough blood pressure to irrigate brain and other important organs).
Now, all
Now to go back to the situation, all the people from the study cited by the Times had (supposedly - didn't read the actual study yet) low blood pressure. Some got blood transfusion, other did not (I suppose they recieved physiological solutions instead).
25% of the blood reciever had heart attacks.
It may be caused, as the sponsor would like us to believe (the company makes NO products), because NO binds to hemoglobine and helps releasing oxygen. And thus the transfused blood was useless because it didn't have enough NO to release enough oxygen. In this case we should buy the company's NO products.
BUT
- Why didn't the physiological receiving patient had problems ? Physiological serum doesn't carry oxygen at all. If NO-less blood is useless at transporting oxygen, non-oxygen-transporting solutions should too...
- Where they compared against a 3rd group receiving only fresh (NO-rich) blood ? No. Where they compared against 4th group receiving NO enriched non-fresh blood ? No, this was only done in lab rats.
- NO is something produced by the body when needed and has a short life (3 hours as they said in stored sample). Presence or absence of NO in the blood can hardly explain stroke happening 30 days later, after 3 hours the NO contained in the transfused blood is already degraded and replaced by NO produced by the patient.
- Other ligands can also increase release of O2 : temperature, CO2, products of degradation of glucose. Hemoglobine has a lot of different way to guess that some body regions are burning a lot of oxygen and that the hemoglobin-bound oxygen should be released more easily.
- Also note that their explanation can only account for the brain hypoxia (lack of oxygen), not the stroke itself (clogged vessels).
On the othe
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
Nitric Oxide is a vasodilator (causes your blood vessels to expand). Thus if you get a blood transfusions and you have a potential of getting a heart attack or stroke from blocked arteries before the transplant (atherosclerosis for example), your blood vessels will constrict and you may crap out. As always, karma link to wikipedia on this
http://en.wikipedia.org/wiki/Endothelium-derived_relaxing_factor
There are ways of going around this, like taking nitroglycerin pills
http://en.wikipedia.org/wiki/Glyceryl_trinitrate_(pharmacology)
Blood doping works. But problem is that viscosity increases and you can crap out. Essentially, blood doping is putting a huge strain on your circulatory system so that there is a little more gas in the tank. Really bad idea. Just like taking steroids. You can crap out anytime.
This is exactly why I get all my blood fresh.
That got a chuckle from me.
.... err, maybe not!
Engineering is the art of compromise.
Whatever happened to artificial blood? I've been reading/hearing about this shit for years. Most of the reports are it's close to being ready or ready right now. Then it just vanishes. It's like someone pulls the plug on it. This would solve all the problems with blood shortage, blood going bad, and blood being tainted. It other words, everything.
Supporting World Peace Through Nuclear Pacification
As another poster said, if you're bleeding out, you want to replace blood as fast as possible. Opening the blood vessels would just make the bleeding worse. Yes, blood transfusions save lives. There is no argument about that. They're not saying that transfusions are bad; in fact, they're asking for clinical trials to find out whether or not the amount (or lack of) nitric oxide is clinically significant. Here are their words on the subject:
From TFA:Stamler agreed on the need for clinical trials.
"Banked blood is truly a national treasure that needs to be protected," Stamler said. "Blood can be life saving, only it is not helping the way we had hoped and in many cases it may be making things worse. In principle, we now have a solution to the nitric oxide problem -- we can put it back -- but it needs to be proven in a clinical trial."
"Slapping lipstick on a pig does NOT make it Natalie Portman. Paris Hilton, maybe, but not Portman." - UncleTogie
While Dr. Stamler's supposition is interesting, I would like to see the data and not an AP or Time magazine story. A search of "JS Stamler" on Pubmed shows 183 papers - 30 of which as first author and almost all dealing with NO. I would guess that he is probably an authority on NO. But that in and of itself does not mean that he is an authority on transfusion medicine, trauma care, surgery, or the like. I am interested to see which variables were controlled, what the power of the study was, and in what fashion data were obtained. The article and abstract are not yet up at the PNAS website.
..naturally I'm biased.
I work in I.T. for ARC, but previous to that, I worked on the front lines, collecting the blood.
Allow me to give you a mini-tour.
First, the donor is required to read and acknowledge that they've read the health history guidelines.
Then the donor is required to get their vitals checked, answer several health related questions.
At that point the donor is placed on the donor bed. Their information is rechecked for accuracy.
Their arm is scrubbed using a two-step method.
The venipuncture is performed.
Now here's the important part. The blood comes into the bad which is filled with an anti-coagulant solution, and for it to be a "good unit"...we can only collect so much blood/per anti-coag...the entire unit is measured by weight @ 610g +/- 5% (for a proper whole blood to anti-coag solution). I may be slightly off on the ratio, it's been a while.
Then the unit is packed on ice, and maintained at a constant temperature.
Then the blood goes to the production lab, where the platelets and plasma are expressed and harvested for other uses.
The red blood cells are then introduced to a red cell preservative, (this is the part that makes the blood viable for 42 days)
The units are then either flash frozen, or they're placed in quarantine until the test results are back from the NTL (national testing lab).
but here's the chink in the armor of the original poster's argument. Our blood supply is so low right now in the US, that his argument is a moot point. 99% of the time, the blood isn't even on the shelf that long. Every 2 seconds, someone in the U.S. needs a transfusion of packed red cells....someone like me, who is 0-, CMV-.....I'm pretty much fucked....there won't be any blood available for me. (so all you O-'s...please go donate...lol)...
Anyway....yes, units do lose their potency over time...but part of the process is to ensure that the donor is healthy, and this helps ensure that when the blood is needed it will be as potent as possible.
At the American Red Cross, we make every effort to make sure that there's blood available when it's needed, where it's needed, and provide the best quality units, at the cheapest price, and make every effort to ensure that it's potent, and safe....that's from the very top of the food chain all the way down the janitors...we all love what we do, and we save lives.
That's not to say that occasionally there might be a 1/1,000,000 unit that didn't do the job, but I like those odds
There are 2 groups of people you can make fun of on the Internet without fear of attack. The illiterate, and the Amish.
"Autologous" donations are donations extracted from you when you're healthy enough, like in advance of surgery, for use later, like when you need it during/after surgery. Currently, it's infrequent, and suffers from the same problems (possibly) identified by this study after a while.
But if you donated blood in advance of surgery, and it were used within a few hours, you could get a credit for blood later on when you need it urgently. If everyone scheduled for surgery were required to donate blood in advance (if they were healthy enough to do so), there would be so much blood available all the time that the fresh stuff would never be in short supply.
The infrastructure is in place right now. The techniques are nearly the same, just a tiny little DB and fridge shuffling to keep the fresh stuff flowing, and discard the extra as it ages.
All that's required to permanently end the incessant "blood shortages" and blood drives that could work on something else instead, would be making these donations a requirement.
--
make install -not war
that killed the pope. Sounds like our guy not only had an anti-papist agenda, but didn't like jews either.
This is my sig.
Ingredients:
1 packet of stored donated blood
2 scoops of NitroTech Hardcore Chocolate powder
16 oz. 2% fat milk
Method:
Mix all ingredients in a blender and transfuse intravenously. Patient will recover instantly and hit the gym.
CAUTION:
Do not use on patients with hernia problems. Hitting gym post transfusion may aggravate condition.
Since Viagra (and smilar drugs) are meant to be some sort of Nitric Oxide booster, maybe adding a small dose of this will keep the patients alive (horny as hell, but alive)!
Donte Alistair Anderson Roberts - hi son!
Karma: Chameleon
Our reports on this problem included RC guy
sayung they don't yet -know- what kind of
bags they use... dim bulbs in the marquis of Life?
...and what don't they understand today?
*SHUDDER*
If the new Nitrous Oxide technologies work out, these guys will be laughing their way to the blood bank. =)
/// Not a super-genius . . . yet. ///
You're leaking stupid all over the place.
We operate a fully non-profit blood donation system in Canada.
If they're just selling it to for profit hospitals? I'm not particularly interested in providing them a product to sell.
I don't really see the point to donating blood to a system that would just as soon leave you to die.