BJA Advance Access published online on January 29, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aem401
Storage of strain-specific rat blood limits cerebral tissue oxygen delivery during acute fluid resuscitation
1 Department of Anaesthesia, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital
2 Department of Physiology
3 Department of Haematology and Transfusion Medicine, St Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8
* Corresponding author: Department of Anaesthesia, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8. E-mail: hareg{at}smh.toronto.on.ca
Background: The effect of blood storage on tissue oxygen delivery has not been clearly defined. Some studies demonstrate reduced microvascular oxygen delivery, whereas others do not. We hypothesize that storage of rat blood will limit its ability to deliver oxygen to cerebral tissue.
Methods: Anaesthetized rats underwent haemorrhage (18 ml kg–1) and resuscitation with an equivalent amount of fresh or 7 day stored strain-specific whole blood. Arterial blood gases, co-oximetry, red cell counts and indices, and blood smears were performed. Hippocampal tissue oxygen tension (PBrO2), regional cerebral blood flow (rCBF), and mean arterial pressure (MAP) were measured before and for 60 min after resuscitation (n=6). Data [mean (SD)] were analysed by ANOVA.
Results: After 7 days, there was a significant reduction in pH, PaO2, an increase in PaCO2, but no detectable plasma haemoglobin in stored rat blood. Stored red blood cell morphology demonstrated marked echinocytosis, but no haemolysis in vitro. MAP and PBrO2 in both groups decreased after haemorrhage. Resuscitation with stored blood returned MAP [92 (SD 16) mm Hg] and PBrO2 [3.2 (0.7) kPa] to baseline, whereas rCBF remained stable [1.2 (0.1)]. Resuscitation with fresh blood returned MAP to baseline [105 (16) mm Hg] whereas both PBrO2 [5.6 (1.5) kPa] and rCBF [1.9 (0.4)] increased significantly (P<0.05 for both, relative to baseline and stored blood group). There was no evidence of haemolysis in vivo.
Conclusions: Although resuscitation with stored blood restored cerebral oxygen delivery to baseline, fresh blood produced a greater increase in both PBrO2 and rCBF. These data support the hypothesis that storage limits the ability of RBC to deliver oxygen to brain tissue.
Keywords: blood, transfusion; brain, blood flow; oxygen, measurements; oxygen, tissue; oxygen delivery
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