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The Solution To The Transfusion Dilemma: Tissue Oxygenation and Critical Hemoglobin

Year 2015, Issue: 1, 7 - 12, 01.03.2015

Büşra Tezcan Nejla Mendil Erdoğan Özcan Erdemli

Abstract

Anemia is a common and serious health problem both among patients undergoing surgery and among those in intensive care units. It is associated with increased patient morbidity and mortality, length of hospital stay and costs. However blood transfusion has been used to treat anemia since the establishment of the first blood donor service in 1921, real transfusion indications are indications are being questioned in various clinical conditions and patient profiles because of the infectious and noninfectious complications and cost increasing effects. Based on this knowledge, studies on this subject have increased rapidly in recent years. The Lungs and particularly the circulatory system are responsible for transporting oxygen to the cells to produce energy through the aerobic metabolism. Therefore, transfusion should be chosen as the treatment modality for decreased tissue oxygenation due to anemia in the perioperative period and intensive care. Determination of the disruption of oxygen supply to the tissues is the key point that may solve the critical dilemma of transfusion and anemia. In this article, the importance and determination of tissue oxygenation in solving this dilemma and the term ‘critical hemoglobin value’ will be reviewed

Keywords

blood transfusion tissue oxygenation

References

  • Ajay Kumar MD. Perioperative managemenet of anemi:Limits of blood transfusion and alternatives to it. Cleveland Clinic Journal Of Medicine Nov 2009;76:4 (112-117)
  • R M Leach, D F Treacher. Oxygen transport – 2. Tissue hypoxia. BMJ Nov 14, 1998;317:1370–1373
  • Rolland N. Pittman. Regulation of tissue oxygenation. Morgan & Claypool Life Sciences 2011.
  • Zander R.The oxygen status of arteriel human blood. Scand J Clin Lab İnvest Suppl 1990;203:187-96.
  • Meier J, Müller M.M, Lauscher P. Perioperative red blood cell transfusion: Harmful or beneficial to the patient? Transfus Med Hemother 2012;39:98-103.
  • Hebert PC, Mc Donald BJ, Tinmouth A. Clinical consequences of anemia and red cell transfusion in the critically ill. Crit Care Clin 2004;20:225-35.
  • Kitchens CS. Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses.Kitchen CS. Am J Med 1993;94:117-9.
  • Weiskopf RB,Viele MK, Feiner J, Kelley S, Lieberman J, Noorani M et al. Human Cardiovascular and Metabolic Response to Acute, Severe Isovolemic Anemia. JAMA 1998;279:217-221.
  • Meier J, Kemming GI, Kisch-Wedel H, Wölkhammer S, Habler OP. Hyperoxic ventilation reduces 6-hour mortality at the critical hemoglobin concentration. Anesthesiology 2004;100:1337.
  • Du Pont-Thibodeau G, Harrington K, Lacroix J. Anemia and red blood cell transfusion in critically ill cardiac patients. Ann Intensive Care 2014;2;4:16
  • Fakhry SM, Fata P. Crit Care. How low is too low? Cardiac risks with anemia. Crit Care 2004;8(Suppl 2): S11–4.
  • Zimmerman JL. Use of blood products in sepsis. An evidence- based review. Crit care Med 2004;32:S542-7.
  • Hayes MA, Yau EH, Timmins AC, Hinds CJ, Watson D. Response of Critically Ill Patients toTredment Aimed at Achieving Supranormal Oxygen Delivery and Consumption. Chest 1993;103:886-95.
  • Khamiees M, Raju P, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA. Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial. Chest 2001;120:1262–70.
  • Van Bommel J, Siegemund M, Henny Chp. Heart, kidney and intestine have different tolerances for anemia. Transl Res 2008:151:110-7.
  • Weiskopf RB, Feiner J, Hopf HW, Viele MK, Watson JJ, Kramer JH et al. Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology 2002:96:871-7.
  • McLaren AT, Marsden PA, Mazer CD, Baker AJ, Stewart DJ, Tsui AK et al. Increased expression of HIF-1alpha, nNOS, and VEGF in the cerebral cortex of anemic rats. Am J Physiol Regul Integr Comp Physiol 2007;292:R403-14.
  • Johannes T, G.Mik E, Nohe B. Ince C. Acute decrease in renal microvascular PO2 during acute normovolemic hemodilution. Am. J Physiol Renal Physiol 2006 Feb;292(2):F796-803.
  • Waelgard L, Dahl BM, Kvarstein G, Tonesen TI. Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia. Acta Anesthesiol Scand 2012;56:2009.
  • Fan F-C, Chen RYZ, Schuessler GB, Chien S. Effects of hematocrit variations on regional hemodynamics and oxygen transport in the dog. Am J Physiol 1980;238:545-52.
  • Murray JF, Escobar E, Rapaport E. Effects of blood viscosity on hemodynamic responses in acute normovolemic anemia. Am J Physiol 1969;216:638–42.
  • Murray JF, Rapaport E. Coronary blood flow and myocardial metabolism in acute experimental anaemia. Cardiovasc Res 1972;6:360–367.
  • Brazier J, Cooper N, Maloney JV Jr, Buckberg G. The adequacy of myocardial oxygen delivery in acute normovolemic anemia. Surgery 1974;75:508-16.
  • Lindner JR, Skyba DM, Goodman NC, Jayaweera AR, Kaul S. Changes in myocardial blood volume with graded coronary stenosis. Am J Physiol 1997;272:H567–75.
  • Nikolsky E, Aymong ED, Halkin A, Grines CL, Cox DA, Garcia E et al. Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: analysis from the Controlled Abciximab and Device İnvestigation to Lower Late Angioplasty Complications (CADILLAC) Trial. Coll Cardiol. 2004;4:44:547-53.
  • Karkouti K, Wijeysundera DN, Beattie WS. Risk associated with preoperative anemia in cardiac surgery: A multicenter cohort study. Circulation 2008;29:117:478-84.
  • Karkouti K, Djaiani G, Borger MA, Beattie WS, Federko L, Wijeysundera D et al. Low hematocrit during cardiopulmonary bypass is associated with increased risk of perioperative stroke in cardiac surgery. Ann Thorac Surg. 2005;80:1381-7.
  • Licker M, Ellenberger C, Murith N et al. Cardiovascular response to acute normovolaemic haemodilution in patients with severe aortic stenosis: assessment with transoesophageal echocardiography. Anaesthesia 2004;59:1170–7.
  • Spahn DR, Seifert B, Pasch T, Schmid ER. Haemodilution tolerance in patients with mitral regurgitation. Anaesthesia 1998;53:20–4.
  • Spahn DR, Zollinger A, Schlumpf RB et al. Hemodilution tolerance in elderly patients without known cardiac disease. Anesthesia and Analgesia 1996;82:681–686.
  • Van Woerkens EC, Trouwborst A, van Lanschot JJ. Profound hemodilution: what is the critical level of hemodilution at which oxygen delivery-dependent oxygen consumption starts in an anesthetized human? Anesthesia and Analgesia 1992;75:818–21.
  • Vallet B, Robin E, Lebuffe G. Venous oxygen saturation as a physiologic transfusion trigger. Critical Care 2010;14:213
  • Whitener S, Konoske R, Mark JB. Pulmonary artery catheter. Best Pract Res Clin Anesthesiol. 2014;28:323-35.
  • Rivers EP, Ander DS, Powell D. Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care. 7:204-11.
  • Reinhart K, Bloss F. The value of venous oximetry. Curr Opin Crit Care. 2005;11:259-63.
  • Colloborative Study Group on Peiroperative ScvO2 Monitoring. Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. Crit Care. 2006;10:R158.
  • Marx G, Reinhart K. Venous oximetry. Curr Opin Crit Care. 2006;12:263-8.
  • Reinhart K, Kuhn H Jr, Hartog C, Bredle DL. Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med 2004;30:1572–8
  • Casserly B, Read R, Levy MM. Hemodynamic monitoring in sepsis. Crit Care Nurs Clin N Am 201;23:149-69.
  • Walley KR. Use of central venous oxygen saturation to guide therapy. Am J Respir Crit Care Med. 2011;1:184:514-20.
  • Futier E, Robin E, Jabaudon M, Guerin R, Petit A, Bazin JE. Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery. Critical Care 2010;14:R193.
  • Mizock BA, Falk JL. Lactic acidosis in critical illness. Crit Care Med. Jan 1992;20:80-93.
  • Stacpoole PW, Wright EC, Baumgartner TG, Bersin RM, Buchalter S, Curry SH, et al. Natural history and course of acquired lactic acidosis in adults. DCA-Lactic Acidosis Study Group. Am J Med. Jul 1994;97:47-54.
  • Reinstrup P, Ståhl N, Mellergard P, Uski T, Ungerstedt U, Nordström CM. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery 2000;47:701-10.
  • Hutchinson PJ, O’Connell, MT, Al-Rawi PG, Maskell LB, Kett-White R, Gupta AK, Richards HK, Hutchinson DB, Kirkpatrick PJ, Pickard JD. Clinical cerebral microdialysis: a methodological study. J Neurosurg 2000;93:37-43.
  • Konstantinos T, Apostolos K, Georgios P. Intraperitoneal microdialysis as a monitoring method in the intensive care unit. Int Surg. 2014;99:729-33.
  • Hare GM, Tsui AK, Crawford JH. Is methemoglobin an inert bystander, biomarker or a mediator of oxidative stress- The example of anemia? Redox Biol. 2013;26:1:65-9.
  • Hare GM, Mu A, Romaschin A. Plasma methemoglobin as a potential biomarker of anemic stress in humans. Can J Anaesth 2012;59:348-56.
  • Schumacker P, Cain SM. The concept of a critical oxygen delivery. Intensive Care Med 1987;13:223-9.
  • Rowell LB, Detry JM, Blackmon JR, Wyss C. Importance of the splanchnic vascular bed in human blood pressure regulation. J Appl Physiol 1972;32:213–20.
  • Mc Cuskey RS. Hepatic and splanchnic microvascular responses to inflammation and shock. Hepatogastroenterology 1999;46(Suppl 2):1464–7.
  • Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin J et al. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992;339:195–9.
  • Maynard N, Bihari D, Beale R, Smithies M, Baldock G, Mason R, McColl I. Assessment of splanchnic oxygenation by gastric tonometry in patients with acute circulatory failure. JAMA 1993;270:1203–10.
  • Ahn H, Ivarsson LE, Johansson K, Lindhagen J, Lundgren O: Assessment of gastric blood flow with laser Doppler flowmetry. Scand J Gastroenterol 1988;23:1203–10.
  • Leung FW, Morishita T, Livingston EH, Reedy T, Guth PH: Reflectance spectrophotometry for the assessment of gastroduodenal mucosal perfusion. Am J Physiol 1987;252:797–804.
  • Sakr Y, Chierego M, Piagnerelli M, Verdant C, Dubois MJ, Koch M, et al. Microvascular response to red blood cell transfusion in patients with severe sepsis. Crit Care Med 2007;35:1639–44.
  • Groner W, Winkelman JW, Harris AG, Ince C, Bouma GJ, Messmer K, Nadeau RG. Orthogonal polarization spectral imaging: a new method for study of the microcirculation. Nat Med 1999;5:1209–12.
  • Baron BJ, Dutton RP, Zehtabchi S. Sublingual capnometry for rapid determination of the severity of hemorrhagic shock. J Trauma 2007;62:120-4.
  • Cem A, Serpil UO, Fevzi T. Efficacy of near-infrared spectrometry for monitoring the cerebrak effects of severe dilutional anemia. Heart Surg Forum 2014;17:154-9.
  • Cerebral andperipheral near-infrared spectroscopy: an alternative transfusion trigger? Torella F, Haynes SL, McCollum CN. Vox Sang 2002;83:254-7.
  • Hopf HW, Hunt TK. Comparison of Clark electrode and optode for measurement of tissue oxygen tension. Adv Exp Med Biol 1994;345:841-47.
  • Clark LC. Monitor and control of blood and tissue oxygen measurements. Trans Am Soc Artif Intern Organs 1956;2.41-8.
  • Hoffman WE, Charbel FT, Edelman G, Ausman JI. Brain tissue oxygen pressure, carbon dioxide pressure, and pH during hypothermic circulatory arrest. Surg Neurol 1996,46:75-9.
  • Ince C, Sinaasappel M. Microcirculatory oxygenation and shunting in sepsis and shock. Crit Care Med 1999;27:1369-77.

Transfüzyon İkileminin Çözümü: Doku Oksijenasyonu ve Kritik Hemoglobin

Year 2015, Issue: 1, 7 - 12, 01.03.2015

Büşra Tezcan Nejla Mendil Erdoğan Özcan Erdemli

Abstract

Anemi hem perioperatif dönemde hem de yoğun bakım hastalarında sık karşılaşılan, mortalite, morbidite, hastanede kalım süreleri ve maliyeti arttıran ciddi bir sağlık sorunudur. İlk kan bankasının kurulduğu 1921 yılından beri sıklıkla transfüzyonla tedavi edilmekteyken transfüzyonun enfeksiyöz ve non enfeksiyöz komplikasyonlarının fark edilmesi, maliyeti arttırıcı etkisinin daha iyi anlaşılmasıyla birlikte gerçek transfüzyon endikasyonları çeşitli klinik durum ve hasta profillerinde sorgulanmaya başlamış ve bu konudaki çalışmalar son yıllarda hızla artmıştır. Akciğerlerle birlikte kardiyovasküler sistem ve özellikle kanın asıl görevi hücrelere aerobik metabolizma aracılığıyla enerji üretebilmeleri için oksijen taşımaktır. Dolayısıyla transfüzyon; ciddi komplikasyonları düşünülerek, perioperatif dönem ve yoğun bakımda anemi nedeniyle doku oksijenasyonu bozuluyorsa uygulanması gereken bir tedavi şekli olmalıdır. Yani doku oksijenasyon bozukluğunun tespiti bu hastalarda transfüzyon ve anemi ikilemini çözecek etkili bir anahtardır. Bu makalede bu ikilemin çözümünde doku oksijenasyonunun önemi, tespiti ve kritik hemoglobin değeri kavramları gözden geçirilecektir

Keywords

kan transfüzyonu doku oksijenasyonu

References

  • Ajay Kumar MD. Perioperative managemenet of anemi:Limits of blood transfusion and alternatives to it. Cleveland Clinic Journal Of Medicine Nov 2009;76:4 (112-117)
  • R M Leach, D F Treacher. Oxygen transport – 2. Tissue hypoxia. BMJ Nov 14, 1998;317:1370–1373
  • Rolland N. Pittman. Regulation of tissue oxygenation. Morgan & Claypool Life Sciences 2011.
  • Zander R.The oxygen status of arteriel human blood. Scand J Clin Lab İnvest Suppl 1990;203:187-96.
  • Meier J, Müller M.M, Lauscher P. Perioperative red blood cell transfusion: Harmful or beneficial to the patient? Transfus Med Hemother 2012;39:98-103.
  • Hebert PC, Mc Donald BJ, Tinmouth A. Clinical consequences of anemia and red cell transfusion in the critically ill. Crit Care Clin 2004;20:225-35.
  • Kitchens CS. Are transfusions overrated? Surgical outcome of Jehovah’s Witnesses.Kitchen CS. Am J Med 1993;94:117-9.
  • Weiskopf RB,Viele MK, Feiner J, Kelley S, Lieberman J, Noorani M et al. Human Cardiovascular and Metabolic Response to Acute, Severe Isovolemic Anemia. JAMA 1998;279:217-221.
  • Meier J, Kemming GI, Kisch-Wedel H, Wölkhammer S, Habler OP. Hyperoxic ventilation reduces 6-hour mortality at the critical hemoglobin concentration. Anesthesiology 2004;100:1337.
  • Du Pont-Thibodeau G, Harrington K, Lacroix J. Anemia and red blood cell transfusion in critically ill cardiac patients. Ann Intensive Care 2014;2;4:16
  • Fakhry SM, Fata P. Crit Care. How low is too low? Cardiac risks with anemia. Crit Care 2004;8(Suppl 2): S11–4.
  • Zimmerman JL. Use of blood products in sepsis. An evidence- based review. Crit care Med 2004;32:S542-7.
  • Hayes MA, Yau EH, Timmins AC, Hinds CJ, Watson D. Response of Critically Ill Patients toTredment Aimed at Achieving Supranormal Oxygen Delivery and Consumption. Chest 1993;103:886-95.
  • Khamiees M, Raju P, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA. Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial. Chest 2001;120:1262–70.
  • Van Bommel J, Siegemund M, Henny Chp. Heart, kidney and intestine have different tolerances for anemia. Transl Res 2008:151:110-7.
  • Weiskopf RB, Feiner J, Hopf HW, Viele MK, Watson JJ, Kramer JH et al. Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology 2002:96:871-7.
  • McLaren AT, Marsden PA, Mazer CD, Baker AJ, Stewart DJ, Tsui AK et al. Increased expression of HIF-1alpha, nNOS, and VEGF in the cerebral cortex of anemic rats. Am J Physiol Regul Integr Comp Physiol 2007;292:R403-14.
  • Johannes T, G.Mik E, Nohe B. Ince C. Acute decrease in renal microvascular PO2 during acute normovolemic hemodilution. Am. J Physiol Renal Physiol 2006 Feb;292(2):F796-803.
  • Waelgard L, Dahl BM, Kvarstein G, Tonesen TI. Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia. Acta Anesthesiol Scand 2012;56:2009.
  • Fan F-C, Chen RYZ, Schuessler GB, Chien S. Effects of hematocrit variations on regional hemodynamics and oxygen transport in the dog. Am J Physiol 1980;238:545-52.
  • Murray JF, Escobar E, Rapaport E. Effects of blood viscosity on hemodynamic responses in acute normovolemic anemia. Am J Physiol 1969;216:638–42.
  • Murray JF, Rapaport E. Coronary blood flow and myocardial metabolism in acute experimental anaemia. Cardiovasc Res 1972;6:360–367.
  • Brazier J, Cooper N, Maloney JV Jr, Buckberg G. The adequacy of myocardial oxygen delivery in acute normovolemic anemia. Surgery 1974;75:508-16.
  • Lindner JR, Skyba DM, Goodman NC, Jayaweera AR, Kaul S. Changes in myocardial blood volume with graded coronary stenosis. Am J Physiol 1997;272:H567–75.
  • Nikolsky E, Aymong ED, Halkin A, Grines CL, Cox DA, Garcia E et al. Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: analysis from the Controlled Abciximab and Device İnvestigation to Lower Late Angioplasty Complications (CADILLAC) Trial. Coll Cardiol. 2004;4:44:547-53.
  • Karkouti K, Wijeysundera DN, Beattie WS. Risk associated with preoperative anemia in cardiac surgery: A multicenter cohort study. Circulation 2008;29:117:478-84.
  • Karkouti K, Djaiani G, Borger MA, Beattie WS, Federko L, Wijeysundera D et al. Low hematocrit during cardiopulmonary bypass is associated with increased risk of perioperative stroke in cardiac surgery. Ann Thorac Surg. 2005;80:1381-7.
  • Licker M, Ellenberger C, Murith N et al. Cardiovascular response to acute normovolaemic haemodilution in patients with severe aortic stenosis: assessment with transoesophageal echocardiography. Anaesthesia 2004;59:1170–7.
  • Spahn DR, Seifert B, Pasch T, Schmid ER. Haemodilution tolerance in patients with mitral regurgitation. Anaesthesia 1998;53:20–4.
  • Spahn DR, Zollinger A, Schlumpf RB et al. Hemodilution tolerance in elderly patients without known cardiac disease. Anesthesia and Analgesia 1996;82:681–686.
  • Van Woerkens EC, Trouwborst A, van Lanschot JJ. Profound hemodilution: what is the critical level of hemodilution at which oxygen delivery-dependent oxygen consumption starts in an anesthetized human? Anesthesia and Analgesia 1992;75:818–21.
  • Vallet B, Robin E, Lebuffe G. Venous oxygen saturation as a physiologic transfusion trigger. Critical Care 2010;14:213
  • Whitener S, Konoske R, Mark JB. Pulmonary artery catheter. Best Pract Res Clin Anesthesiol. 2014;28:323-35.
  • Rivers EP, Ander DS, Powell D. Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care. 7:204-11.
  • Reinhart K, Bloss F. The value of venous oximetry. Curr Opin Crit Care. 2005;11:259-63.
  • Colloborative Study Group on Peiroperative ScvO2 Monitoring. Multicentre study on peri- and postoperative central venous oxygen saturation in high-risk surgical patients. Crit Care. 2006;10:R158.
  • Marx G, Reinhart K. Venous oximetry. Curr Opin Crit Care. 2006;12:263-8.
  • Reinhart K, Kuhn H Jr, Hartog C, Bredle DL. Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med 2004;30:1572–8
  • Casserly B, Read R, Levy MM. Hemodynamic monitoring in sepsis. Crit Care Nurs Clin N Am 201;23:149-69.
  • Walley KR. Use of central venous oxygen saturation to guide therapy. Am J Respir Crit Care Med. 2011;1:184:514-20.
  • Futier E, Robin E, Jabaudon M, Guerin R, Petit A, Bazin JE. Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery. Critical Care 2010;14:R193.
  • Mizock BA, Falk JL. Lactic acidosis in critical illness. Crit Care Med. Jan 1992;20:80-93.
  • Stacpoole PW, Wright EC, Baumgartner TG, Bersin RM, Buchalter S, Curry SH, et al. Natural history and course of acquired lactic acidosis in adults. DCA-Lactic Acidosis Study Group. Am J Med. Jul 1994;97:47-54.
  • Reinstrup P, Ståhl N, Mellergard P, Uski T, Ungerstedt U, Nordström CM. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery 2000;47:701-10.
  • Hutchinson PJ, O’Connell, MT, Al-Rawi PG, Maskell LB, Kett-White R, Gupta AK, Richards HK, Hutchinson DB, Kirkpatrick PJ, Pickard JD. Clinical cerebral microdialysis: a methodological study. J Neurosurg 2000;93:37-43.
  • Konstantinos T, Apostolos K, Georgios P. Intraperitoneal microdialysis as a monitoring method in the intensive care unit. Int Surg. 2014;99:729-33.
  • Hare GM, Tsui AK, Crawford JH. Is methemoglobin an inert bystander, biomarker or a mediator of oxidative stress- The example of anemia? Redox Biol. 2013;26:1:65-9.
  • Hare GM, Mu A, Romaschin A. Plasma methemoglobin as a potential biomarker of anemic stress in humans. Can J Anaesth 2012;59:348-56.
  • Schumacker P, Cain SM. The concept of a critical oxygen delivery. Intensive Care Med 1987;13:223-9.
  • Rowell LB, Detry JM, Blackmon JR, Wyss C. Importance of the splanchnic vascular bed in human blood pressure regulation. J Appl Physiol 1972;32:213–20.
  • Mc Cuskey RS. Hepatic and splanchnic microvascular responses to inflammation and shock. Hepatogastroenterology 1999;46(Suppl 2):1464–7.
  • Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin J et al. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992;339:195–9.
  • Maynard N, Bihari D, Beale R, Smithies M, Baldock G, Mason R, McColl I. Assessment of splanchnic oxygenation by gastric tonometry in patients with acute circulatory failure. JAMA 1993;270:1203–10.
  • Ahn H, Ivarsson LE, Johansson K, Lindhagen J, Lundgren O: Assessment of gastric blood flow with laser Doppler flowmetry. Scand J Gastroenterol 1988;23:1203–10.
  • Leung FW, Morishita T, Livingston EH, Reedy T, Guth PH: Reflectance spectrophotometry for the assessment of gastroduodenal mucosal perfusion. Am J Physiol 1987;252:797–804.
  • Sakr Y, Chierego M, Piagnerelli M, Verdant C, Dubois MJ, Koch M, et al. Microvascular response to red blood cell transfusion in patients with severe sepsis. Crit Care Med 2007;35:1639–44.
  • Groner W, Winkelman JW, Harris AG, Ince C, Bouma GJ, Messmer K, Nadeau RG. Orthogonal polarization spectral imaging: a new method for study of the microcirculation. Nat Med 1999;5:1209–12.
  • Baron BJ, Dutton RP, Zehtabchi S. Sublingual capnometry for rapid determination of the severity of hemorrhagic shock. J Trauma 2007;62:120-4.
  • Cem A, Serpil UO, Fevzi T. Efficacy of near-infrared spectrometry for monitoring the cerebrak effects of severe dilutional anemia. Heart Surg Forum 2014;17:154-9.
  • Cerebral andperipheral near-infrared spectroscopy: an alternative transfusion trigger? Torella F, Haynes SL, McCollum CN. Vox Sang 2002;83:254-7.
  • Hopf HW, Hunt TK. Comparison of Clark electrode and optode for measurement of tissue oxygen tension. Adv Exp Med Biol 1994;345:841-47.
  • Clark LC. Monitor and control of blood and tissue oxygen measurements. Trans Am Soc Artif Intern Organs 1956;2.41-8.
  • Hoffman WE, Charbel FT, Edelman G, Ausman JI. Brain tissue oxygen pressure, carbon dioxide pressure, and pH during hypothermic circulatory arrest. Surg Neurol 1996,46:75-9.
  • Ince C, Sinaasappel M. Microcirculatory oxygenation and shunting in sepsis and shock. Crit Care Med 1999;27:1369-77.
There are 64 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Büşra Tezcan

Nejla Mendil Erdoğan

Özcan Erdemli

Publication Date March 1, 2015
Published in Issue Year 2015Issue: 1

Cite

EndNote Tezcan B, Erdoğan NM, Erdemli Ö (March 1, 2015) Transfüzyon İkileminin Çözümü: Doku Oksijenasyonu ve Kritik Hemoglobin. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 7–12.