Nassim Ait Abdallah1,2,3, Philippe Connes3,4,5, Gaetana Di Liberto6,7, Lucile Offredo8, Jean Louis Beaumont7, Dehbia Menouche7, Karima Debbache1,2,3, Amna Jebali1,2,3, Anoosha Habibi1,2,3,6, France Pirenne3,6,7, Frédéric Galacteros1,2,3,6, Brigitte Ranque3,8,9, Pablo Bartolucci1,2,3,6. 1. Centre de Référence des Syndromes Drépanocytaires Majeurs, Médecine interne, Université Paris-Est Créteil, Créteil, France. 2. Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France. 3. Laboratoire d'Excellence GR-Ex, Paris, France. 4. Laboratoire LIBM EA7424, Team "Vascular Biology and Red Blood Cell", Université Lyon 1, Villeurbanne, France. 5. Institut Universitaire de France, Paris, France. 6. Institut Mondor, IMRB Equipe 2: Transfusion et Maladies du Globule Rouge, Creteil, France. 7. Etablissement Français du Sang, Île-de-France Mondor, Creteil, France. 8. INSERM U970 - Centre de recherche Cardiovasculaire de Paris, Equipe Epidemiologie Cardiovasculaire et Mort Subite, Paris, France. 9. Service de Médecine Interne, Hopital Européen George Pompidou, APHP, Paris, France.
Abstract
BACKGROUND: Blood transfusion is the cornerstone treatment to reduce the clinical severity of sickle cell disease (SCD), but we need to maintain the haematocrit (Hct) within an acceptable range to avoid a deleterious increase in blood viscosity. The aim of this study was to compare the effects of manual versus automated red blood cell (RBC) Exchange on haematological parameters and blood viscosity. STUDY DESIGN AND METHODS: This prospective, single-centre, open nonrandomized observational study included forty-three sickle cell patients: 12 had automated RBC Exchange and 31 manual RBC Exchange. Samples were collected in EDTA tubes just before and within one hour after the end of the RBC Exchange to measure the haematological parameters and blood viscosity. RESULTS: Both automated and manual RBC Exchange decreased haemoglobin S levels and leucocyte and platelet counts, but the decrease was greater for automated RBC Exchange. Manual RBC Exchange caused a significant rise in haematocrit and haemoglobin levels and did not change blood viscosity. In contrast, automated RBC Exchange decreased blood viscosity without any significant change in haematocrit and only a very slight increase in haemoglobin levels. The change in blood viscosity correlated with the modifications of haematocrit and haemoglobin levels, irrespective of the RBC Exchange procedure. When adjusted for the volume of RBC Exchange, the magnitude of change in each biological parameter was not different between the two procedures. CONCLUSION: Our study demonstrates that the automated RBC Exchange provided greater haematological and haemorheological benefits than manual RBC Exchange, mainly because of the higher volume exchanged, suggesting that automated RBC Exchange should be favoured over manual RBC Exchange when possible and indicated.
BACKGROUND: Blood transfusion is the cornerstone treatment to reduce the clinical severity of sickle cell disease (SCD), but we need to maintain the haematocrit (Hct) within an acceptable range to avoid a deleterious increase in blood viscosity. The aim of this study was to compare the effects of manual versus automated red blood cell (RBC) Exchange on haematological parameters and blood viscosity. STUDY DESIGN AND METHODS: This prospective, single-centre, open nonrandomized observational study included forty-three sickle cell patients: 12 had automated RBC Exchange and 31 manual RBC Exchange. Samples were collected in EDTA tubes just before and within one hour after the end of the RBC Exchange to measure the haematological parameters and blood viscosity. RESULTS: Both automated and manual RBC Exchange decreased haemoglobin S levels and leucocyte and platelet counts, but the decrease was greater for automated RBC Exchange. Manual RBC Exchange caused a significant rise in haematocrit and haemoglobin levels and did not change blood viscosity. In contrast, automated RBC Exchange decreased blood viscosity without any significant change in haematocrit and only a very slight increase in haemoglobin levels. The change in blood viscosity correlated with the modifications of haematocrit and haemoglobin levels, irrespective of the RBC Exchange procedure. When adjusted for the volume of RBC Exchange, the magnitude of change in each biological parameter was not different between the two procedures. CONCLUSION: Our study demonstrates that the automated RBC Exchange provided greater haematological and haemorheological benefits than manual RBC Exchange, mainly because of the higher volume exchanged, suggesting that automated RBC Exchange should be favoured over manual RBC Exchange when possible and indicated.
Authors: Scott T Avecilla; Farid Boulad; Karina Yazdanbakhsh; Michel Sadelain; Patricia A Shi Journal: Transfusion Date: 2021-06-23 Impact factor: 3.337
Authors: Olivier Hequet; Camille Boisson; Philippe Joly; Daniela Revesz; Kamila Kebaili; Alexandra Gauthier; Celine Renoux; Severine Creppy; Elie Nader; Jean François Nicolas; Frédéric Berard; Fabrice Cognasse; Marc Vocanson; Yves Bertrand; Philippe Connes Journal: Front Med (Lausanne) Date: 2021-12-22