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The MEDLINE database was searched from 1966 to April 2013 to ﬁnd randomized trials evaluating a restrictive hemoglobin transfusion trigger of <7 g/dL, compared with a more liberal trigger.
A study of patients undergoing cardiac surgical procedures who refused blood transfusions Low preoperative hemoglobin signiﬁcant independent predictor of noncardiac adverse events Minimum hematocrit signiﬁcant risk factor for postoperative mortality Lowest hematocrit signiﬁcantly associated with increased risk of in-hospital mortality, need for intraaortic balloon pump, and return to cardiopulmonary bypass Lowest hematocrit signiﬁcantly associated with worse renal function, more myocardial injury, longer ventilator support, longer hospital stay, and increased mortality Lowest hematocrit associated with increased risk of postoperative stroke for religious reasons found a 0% mortality rate but a 9.4% morbidity rate in those with a postoperative hemoglobin of 7.1 to 8.0 g/dL (Table 2) .
Estimates suggest that every year approximately 300,000 infants are born with sickle cell anemia, which is defined as homozygosity for the sickle hemoglobin (HbS) gene (i.e., for a missense mutation [Glu6Val, rs334] in the β-globin gene [HBB]) and that this number could rise to 400,000 by 2050.1 Although early diagnosis, penicillin prophylaxis, blood transfusion, transcranial Doppler imaging, hydroxyurea, and hematopoietic stem-cell transplantation can dramatically improve survival and quality of life for patients with sickle cell disease, our understanding of the role of genetic and nongenetic factors in explaining the remarkable phenotypic diversity of this mendelian disease is still limited.
Five Things Physicians and Patients Should Question 1 Don’t initiate erythropoiesis-stimulating agents (ESAs) in chronic kidney disease (CKD) patients with hemoglobin levels greater than or equal to 100 g/L without symptoms of anemia.
In the setting of protocolized glycemic control, the relationship between postoperative glycemic variability on major adverse events (MAEs) after cardiac surgery is unknown for patients with increased preoperative hemoglobin A1C (HbA1C >6.5%).
Developing fetuses and newborn infants are more vulnerable to carbon monoxide poisoning because of the persistence of fetal hemoglobin.
calcium, phosphorus, hemoglobin, white blood cell count, eosinophil (%), mean platelet volume (MPV), 25(OH)D levels were measured in each case.
Eastern Cooperative Oncology Group performance status (ECOG-PS), baseline hemoglobin (g/dl), alkaline phosphate (UI/l), albumin (g/dl), PSA (ng/ml) levels, presence of pain-related symptoms ( 3 on the visual analogue pain scale) and the extent of the disease (minimal disease vs.
Demographic characteristics (age, gender, diabetes mellitus, current smoking, and duration of dialysis), laboratory variables [hemoglobin, blood urea nitrogen, serum levels of creatinine, albumin, phosphorus, and calcium, alkaline phosphatase, a single determination of the albumin/creatinine ratio (ACR) in a spot urine sample, and fasting lipid profile], clinical parameters (systolic and diastolic blood pressure, and body mass index) were obtained from all study participants.
Levels of pre-treatment platelet count, hemoglobin, serum alkaline phosphatase (ALP), serum lactate dehydrogenase (LDH) and PSA were measured prior to initial DEC therapy, and only PSA levels were measured every 3 months thereafter.
www.ebmedicine.net/pempissues This disrupts the ability of the hemoglobin molecule to carry oxygen, which, in turn, can cause tissue hypoxemia.
Heme (the blood hemoglobin cofactor) is a vital but toxic molecule for nearly all organisms.
This model postulates that tetrapyrrole pigments, including hemoglobin and bilirubin, are blood-borne photoreceptors, regulating gasotransmitters such as carbon monoxide when exposed to light in the eye.
However, all subjects had normal hemoglobin and whole-blood folic acid levels.
The test utilizes the peroxidase activity of hemoglobin to catalyze a chemical reaction that converts chromogen tetramethylbenzidine to an oxidized chromogen, which has a green-blue color.5 This testing has a reported sensitivity as high as 100% and a specificity of 99% to detect 5 Copyright © 2014 EB Medicine.
i Abbreviations 3-NT ADH Ang II Arg ALR2 ALS BAEC BCA BH4 BKCa BSA CaM CBS cGMP CSE Cys CysNO DAF-2 DA DAN deoxyHb DMSO DTNB DTPA DTT EDRF EDTA EPR ESI EtOH FAD FMN FPLC Grx GSH GSNO GSSG Hb HbNO HbSNO 3-Nitrotyrosine Alcohol dehydrogenase Angiotensin II L-Arginine Aldose reductase (aldehyde reductase 2) Amyotrophic lateral sclerosis Bovine aortic endothelial cells Bicinchoninic acid Tetrahydrobiopterin Big-conductance Ca2+ -activated K+ channel Bovine serum albumin Calmodulin Cystathionine β-synthase Cyclic guanosine monophosphate Cystathionine γ-lyase L-Cysteine L-S -Nitrosocysteine (SNOC) DAF-2 diacetate, 4,5-diaminofluorescein diacetate 2,3-Diaminonaphthalene Deoxyhemoglobin (unliganded ferrous Hb) Dimethyl sulphoxide 5,5’-Dithio-bis(2-nitrobenzoic acid), Ellman’s reagent Diethylenetriaminepentaacetic acid Dithiothreitol Endothelium derived relaxing factor (• NO) Ethylenediamine tetraacetic acid Electron paramagnetic resonance spectroscopy Electrospray ionisation Ethanol Flavin adenine dinucleotide Flavin mononucleotide Fast protein liquid chromatography Glutaredoxin Glutathione, reduced S -Nitrosoglutathione Glutathione, oxidized Hemoglobin Nitrosylhemoglobin S -Nitrosohemoglobin ii Abbreviations HO HPLC HUVEC IC50 IRP-1 LC/MS LMW L-NAME Mb metHb mtNOS NAT NOHA NOS NOS-1 NOS-2 NOS-3 NOX oxyHb PG PGHS-2 PGI2 PN ppm PTP RLU RNS ROS SD sGC SIN-1 SMC SNAP SNP SOD SOD1 SOD2 SOD3 TCA TLC Trx Tx VEGF VSMC w/o XO YC-1 Heme oxygenase High pressure liquid chromatography Human vascular endothelial cells Half-maximal inhibition concentration Iron regulatory protein-1 Liquid chromatography/mass spectroscopy Low-molecular-weight N ω -Nitro-L-arginine methyl ester Myoglobin Methemoglobin (ferric Hb) Mitochondrial NOS 2,3-Naphthotriazole N ω -Hydroxy-L-arginine Nitric oxide synthase Neuronal NOS (nNOS) Inducible NOS (iNOS) Endothelial NOS (eNOS) NADPH oxidase Oxyhemoglobin (oxygenated ferrous Hb) Prostaglandin Prostaglandin H synthase-2 Prostacyclin Peroxynitrite parts per million Permeability transition pore Relative light unit Reactive nitrogen species Reactive oxygen species Standard deviation Soluble guanylate cyclase 3-Morpholino-sydnonimine Smooth muscle cells N -(Acetyloxy)-3-nitrosothiovaline Sodium nitroprusside Superoxide dismutase Cu,Zn-SOD, cytosolic Mn-SOD, mitochondrial EC-SOD, extracellular Cu,Zn-SOD Tricarboxylic acid Thin-layer chromatography Thioredoxin Thromboxane Vascular endothelial growth factor Vascular smooth muscle cells without Xanthine oxidase 1-Benzyl-3-(5-hydroxymethyl-2-furyl)indazole iii Publications Results from this work were published in the following articles:
(Continued.) Characteristic Albumin Group (N = 903) Crystalloid Group (N = 907) 105±22 74±16 10.0±4.9 106±20 73±15 9.8±4.7 50 20–100 50 25–100 2.3 1.4–4.2 24.1±6.3 10.9±2.1 2.5 1.6–4.3 24.2±6.2 11.0±2.0 73 65–79 73 68–80 8 6–10 8 5–10 188 (20.8) 361 (40.0) 236 (26.1) 89 (9.9) 29 (3.2) 565 (62.6) 709 (78.5) 208 (22.9) 303 (33.4) 248 (27.3) 115 (12.7) 33 (3.6) 570 (62.8) 737 (81.3) 153 (16.9) 452 (50.1) 176 (19.4) 479 (52.8) Physiological variable¶ Heart rate — beats/min Mean arterial pressure — mm Hg Central venous pressure — mm Hg Urine output — ml/hr Median Interquartile range Lactate — mmol/liter Median Interquartile range Serum albumin — g/liter Hemoglobin — g/dl Central venous oxygen saturation — % Median Interquartile range SOFA score‖ Median Interquartile range Organ dysfunction — no.