Anemia Clinical Trial
Official title:
Red Blood Cell Transfusion and Skeletal Muscle Tissue Oxygenation in Anaemic Haematologic Outpatients
The aim of the present study was to re-challenge the current data that anaemia in chronically anaemic haematology patients is not associated with low skeletal muscle StO2, and that the age of RBCs does not influence tissue responses. The investigators investigated these aspects using improved technology NIRS devices, for deeper tissue penetration and removal of the superficial signal from the skin.
Anaemia is state of decreased blood oxygen carrying capacity . Acute anaemia is associated
with increased tissue oxygen extraction . On the other hand, with chronic anaemia human body
has time to at least partially adapt to decreased blood oxygen carrying capacity , .
Near-infrared spectroscopy (NIRS) is non-invasive method to assess tissue oxygenation (StO2)
and estimate tissue haemoglobin (THb) levels . The investigators have studied skeletal
muscle StO2 in critically ill patients with preserved oxygen (i.e., cardiogenic shock) and
with impaired oxygen extraction (i.e., septic shock) , , . In addition to measuring resting
StO2, the investigators performed vascular occlusion tests to stop arterial blood flow, to
estimate oxygen consumption, and at the end of the occlusion, it was also possible to
estimate vascular reactivity and maximal reperfusion capability .
Under acute blood loss in trauma patients, the skeletal muscle StO2 measured by NIRS
correlates with blood haemoglobin (Hb) and delivery of oxygen, and can easily detect latent
stage of haemorrhagic shock . Unexpectedly, chronically anaemic haematology patients with
preserved oxygen extraction capability did not show low skeletal StO2 and THb index despite
their severe anaemia, which is what would be predicted from normal physiological responses .
It is known that there are structural and functional changes to RBCs during storage. Recent
study detected deleterious effects of RBC storage on microvascular responses to transfusion
in stable anaemic trauma patients .
The aim of the present study was to re-challenge the current data that anaemia in
chronically anaemic haematology patients is not associated with low skeletal muscle StO2,
and that the age of RBCs does not influence tissue responses. The investigators investigated
these aspects using improved technology NIRS devices, for deeper tissue penetration and
removal of the superficial signal from the skin.
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