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Efficacy of fresh packed red blood transfusion in organophosphate poisoning.

Abstract The mortality rate caused by organophosphate (OP) poisoning is still high, even the standard treatment such as atropine and oxime improves a lot. To search for alternative therapies, this study was aimed to investigate the effects of packed red blood cell (RBC) transfusion in acute OP poisoning, and compare the therapeutic effects of RBCs at different storage times.Patients diagnosed with OP poisoning were included in this prospective study. Fresh RBCs (packed RBCs stored less than 10 days) and longer-storage RBCs (stored more than 10 days but less than 35 days) were randomly transfused or not into OP poisoning patients. Cholinesterase (ChE) levels in blood, atropine usage and durations, pralidoxime durations were measured.We found that both fresh and longer-storage RBCs (200-400 mL) significantly increased blood ChE levels 6 hours after transfusion, shortened the duration for ChE recovery and length of hospital stay, and reduced the usage of atropine and pralidoxime. In addition, fresh RBCs demonstrated stronger therapeutic effects than longer-storage RBCs.Packed RBCs might be an alternative approach in patients with OP poisoning, especially during early stages.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28296779
OWN - NLM
STAT- MEDLINE
DA  - 20170315
DCOM- 20170410
LR  - 20170410
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 11
DP  - 2017 Mar
TI  - Efficacy of fresh packed red blood transfusion in organophosphate poisoning.
PG  - e6375
LID - 10.1097/MD.0000000000006375 [doi]
AB  - The mortality rate caused by organophosphate (OP) poisoning is still high, even
      the standard treatment such as atropine and oxime improves a lot. To search for
      alternative therapies, this study was aimed to investigate the effects of packed 
      red blood cell (RBC) transfusion in acute OP poisoning, and compare the
      therapeutic effects of RBCs at different storage times.Patients diagnosed with OP
      poisoning were included in this prospective study. Fresh RBCs (packed RBCs stored
      less than 10 days) and longer-storage RBCs (stored more than 10 days but less
      than 35 days) were randomly transfused or not into OP poisoning patients.
      Cholinesterase (ChE) levels in blood, atropine usage and durations, pralidoxime
      durations were measured.We found that both fresh and longer-storage RBCs (200-400
      mL) significantly increased blood ChE levels 6 hours after transfusion, shortened
      the duration for ChE recovery and length of hospital stay, and reduced the usage 
      of atropine and pralidoxime. In addition, fresh RBCs demonstrated stronger
      therapeutic effects than longer-storage RBCs.Packed RBCs might be an alternative 
      approach in patients with OP poisoning, especially during early stages.
FAU - Bao, Hang-Xing
AU  - Bao HX
AD  - aFirst Clinical Medical College of Zhejiang Chinese Medical University bZhejiang 
      Provincial Hospital of TCM cDepartment of Laboratory Medicine, Zhejiang
      Provincial People's Hospital, People's Hospital of Hangzhou Medical College
      dDepartment of Transfusion, Zhejiang Provincial People's Hospital, People's
      Hospital of Hangzhou Medical College, Hangzhou eInstitute of Neuroscience and
      Institute of Hypoxia Medicine, Wenzhou Medical University, Wenzhou fDepartment of
      Transfusion, Lishui People's Hospital, Lishui, Zhejiang, China.
FAU - Tong, Pei-Jian
AU  - Tong PJ
FAU - Li, Cai-Xia
AU  - Li CX
FAU - Du, Jing
AU  - Du J
FAU - Chen, Bing-Yu
AU  - Chen BY
FAU - Huang, Zhi-Hui
AU  - Huang ZH
FAU - Wang, Ying
AU  - Wang Y
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Cholinesterase Reactivators)
RN  - 0 (Pralidoxime Compounds)
RN  - 7C0697DR9I (Atropine)
RN  - EC 3.1.1.8 (Cholinesterases)
RN  - P7MU9UTP52 (pralidoxime)
SB  - AIM
SB  - IM
MH  - Acute Disease
MH  - Atropine/therapeutic use
MH  - Cholinesterase Reactivators/therapeutic use
MH  - Cholinesterases/blood
MH  - Erythrocyte Transfusion/*methods
MH  - Female
MH  - Gastric Lavage
MH  - Humans
MH  - Male
MH  - Organophosphate Poisoning/drug therapy/*therapy
MH  - Pralidoxime Compounds/therapeutic use
MH  - Prospective Studies
MH  - Time Factors
PMC - PMC5369934
EDAT- 2017/03/16 06:00
MHDA- 2017/04/11 06:00
CRDT- 2017/03/16 06:00
AID - 10.1097/MD.0000000000006375 [doi]
AID - 00005792-201703170-00060 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Mar;96(11):e6375. doi: 10.1097/MD.0000000000006375.

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