The potential dangers of blood transfusions

I just read a very interesting "Fox News" article from Tuesday, October 9, 2007, entitled, "Study finds stored blood lacks nitric oxide, may trigger heart attack, strokes in recipients" http://www.foxnews.com/  This is vital information that savvy health care consumers would want to read regarding little known issues involved with accepting a blood transfusion.

Millions of people who have accepted blood transfusions assume that the blood supply is free from contamination by HIV, hepatitis, lyme disease and other blood borne diseases. But there are other issues with blood that have not received as much attention. 

 Let's take a look at this very important substance.

Nitric oxide - how important

According to the report, most of the stored blood given to millions of people lack a component vital for it to deliver oxygen to the tissues.  Nitric oxide, a substance that helps keep blood vessels open, breaks down as soon as the blood goes into storage.  Information published by two research teams in separate studies in Proceeding of the National Academy of Sciences bears this out.

Blood vessels relax and constrict to regulate blood flow.  Nitric oxide opens up the blood vessels and allows the red blood cells to deliver oxygen, according to Dr. Jonathan Stamler of Duke University, a research leader.

The second research team led by Dr. Timothy McMahon studied the changes in stored blood over time.  At present,  blood is kept in blood banks up to 42 days.  After this, it must be discarded.  According to Dr. McMahon, nitric oxygen depletion begins within 3 hours.  Researchers have long known about this fact, yet blood has been transfused without this vital substance.  Many heart attacks and strokes have been the results.

To read the entire article, go to the October 9, 2007 http://www.foxnews.com/ article, "Study Finds stored blood lacks nitric oxide, may trigger heart attack, strokes in recipients."

What is the cell saver?

Bloodless medical procedures depend upon the skill of highly trained surgeons, nurses, perfusionists and other supportive personnel. Included in the care of patients undergoing such procedures are machines and  equipment whose use requires highly technical skill  to assure positive patient outcomes after surgery.  One such tool is the cell saver. What is the function of this machine during a bloodlesss procedure?

What is the cell saver?

The cell saver is a machine that collects blood lost through surgery.   There are two types of machines that are used to perform this procedure:

1.RBC (red blood cell) washing type.  This type of machine collects, washes and removes the red blood cells by centrifuge.  It then reinfuses them. 

These RBC wahing devices can also cleanse toxins from the blood.  They also remove platelets and clotting factors (both are important in blood clotting)  These machines are also of variable design and capacity.  They are also more costly but have more positive patient outcomes.

2. Hemofiltration type.  The hemofiltration type just collects blood, filters  and reinfuses it. These machines can return all of the blood elements including the platelets and clotting factors.  The contaminants are also present.

What are indications and contraindications for Cell Saver?
Generally, cell saver use is likely if the blood loss is 1000ml (one liter) or, in the past, 20% of the patient's estimated volume.  Also, if a procedure has  usually required a blood transfusion. A list of some common surgeries where it is used are as follows:

Cardiac - valve replacement.

Orthopedic - major spine surgery.
                     bilateral knee replacement.

Urology - radical retropubic prostatetomy.
                Cystectomy

Vascular - thoraco abdominal-aortic aneurysm repair.

Contraindications

Blood that has been contaminated with urine, feces, bone fragments or amniotic fluid.

Malignancy

Hematologic disease - sickle cell or thallessemia.

If you are contemplating surgery, talk with your physician or surgeon regarding the possibility of cell saver during the procedure. As individual factors must be taken into consideration.

Sources:

Freischlag, Julie, "Intraoperative blood salvage in vascular surgery - worth the effort? http://www.ccforum.com/
Waters, Jonathan H., "Indications and contraindications of cell salvage" http://www.bplmedical.com/

Acai and your cholesterol

With the numbers of younger Americans growing that suffer from high cholesterol, the numbers of those taking the statins for this problem is likely to grow as well. Unfortunately, taking this prescription medication will likely introduce the medication user to many side effects including memory loss and depression to anaphylaxis.  As a result, people are turning to more natural and less drastic methods such as acai.*

What effect does acai have on blood cholesterol?

Acai has been dubbed the "super fruit" from Brazil. The indigenous people have consumed this food for thousands of years and have enjoyed cardiovascular protection.  New to the United States, many are discovering the immeasurable health benefits that acai bestow. One of those is the lowering of cholesterol.

Acai is high in omega 3, 6 and 9 all of which are essential fatty acids (EFA) that help clear the body of
unwanted cholesterol.  Specifically, these EFAs clear the body of the LDL (low density lipoprotein) or "bad" cholesterol that in excessive amounts can clog blood vessels and lead to heart attack, strokes and high blood pressure.  At the same time, they increase the high density lipoproteins (HDL) or "good" cholesterol.

Acai is also full of antioxidants, which battle the effects of free radical damage, thus making it an important weapon in delaying some of the effects of aging and in fighting disease such as diabetes and some forms of cancer.

Acai is also high in beta-sitosterol which also is important in lowering cholesterol . It inhibits its absorption in the small intestine.  Beta sitosterol has also received attention for its use in Europe in prostate and breast cancers.

A cause for concern in obtaining the nutritional benefits of acai has been that the fruit perishes in 24 hours.  However, with modern refrigeration techniques,  most of its beneficial protective properties have been preserved.

*Please note that this article is not intended to dissuade anyone from taking their prescription medication.  Speak to your primary care physician and nutritionist to develop an effective treatment plain if you have high cholesterol.

Related articles

• Statins Over Prescribed (mickirose.wordpress.com)
• 'Statins for all' - and billions for drug firms (telegraph.co.uk)
• Analysis cautions against widespread use of cholesterol-lowering drugs (truthonmedecine.wordpress.com)

What is a Perfusionist?

The medical professionals involved in bloodless surgery programs are many and come from various backgrounds in medical science.  Everyone knows that the teams consist of highly skilled surgeons, nurses, and anesthesiologists.  But who are the less visible, ancillary members of the team whose expertise is in the operation and function of the high tech machinery in the OR? They are none other than perfusionists. These skilled individuals are essential personnel in surgery and especially in bloodless surgery.   Let's take a look at who they are and what they do.

What is a Perfusionist?

A perfusionist is a health care professional who specializes in the operation of of the heart-lung machines in cardio-thoracic surgery. The heart-lung machine keeps the patient alive by pumping oxygenated blood throughout the operation.  The perfusionist also closely monitors the patient's circulatory status and advises the team of any changes. This involves monitoring the oxygen and carbon dioxide for critical changes.

They are also involved in the insertion and operation of (VAD) ventricular assist devices or artificial hearts.  The job of the VAD is to pump blood for the weakened left ventricle, the main pumping chamber which pumps blood to the rest of the body.

The perfusionists may also be involved in other types of surgery as well.

Source:
"Bloodless Cardiac Surgery: 'What is a perfusionist, what is his role in bloodless medicine?'
http://www.bloodlessmed.org/

New GYN procedure may eliminate the need for hysterectomy and blood transfusions

I just read a really interestng article about a procedure that is being done in Allegheny General Hospital, GYN Division, Pittsburgh, PA. Hopefully, this information may open the door for Jehovah's Witnesses and others seeking to minimize the risk of hysterectomy and blood transfusions.  The Procedure has been dubbed "Bloodless myomectomy."

Women with large sized fibroids and an enlarged uterus are often confronted with  undergoing a hysterectomy (removal of the uterus), due to the fact that a myomectomy (surgical removal of fibroids with the uterus remaining intact) often involves a sizeable blood loss.

At Allegheny General Hospital, GYN Surgeon, Dr. Jan Leski, has been performing a bloodless myomectony which may not necessitate the hysterectomy thus allowing a woman to retain the ability to later birth children albeit by caesarean section.

The surgery

Dr. Leski, isolates and clamps blood vessels to  he reproductive organ to temporarily shut off the blood flow to the area.  He then remove the fibroids and rebuilds the uterus using tissue from the patient's abdominal wall to reduce the formation of adhesions(scar tissue) that could later be a source of bleeding and infection.

This procedure is particularly beneficial when the  uterus has become enlarged due to the fibroids (an enlarged uterus is subject to bleeding  which would then require blood transfusions.)

For more information about this procedure, please visit http://www.bloodlessmedicine.org/ "An alternative to hysterectomy: A Doctor's Perspective" Look under archives to find the article.