Pathology - Mounting robustly / hemoglobin

Author

Mounting robustly / hemoglobin

ironjustice@aol.com

2006-06-04, 9:21 am

In the mouse .. model .. a hemoglobin of 6 .. doesn't seem to .. bother
... it .. a .. bit ..
------------------------------------------------------------------

A reduction of hemoglobin concentration to a subnormal level increased
oxygen consumption without lowering oxygen delivery.

http://tinyurl.com/2zffh
------------------------------------------------------

This might / would go right along with the runners PARADOX of a
hemoglobin .. COMMONLY .. of .. 9 .. http://tinyurl.com/jvvu7

and the hemoglobin of pregnant women who TEND TO HAVE LIVE BIRTHS..
http://news.bbc.co.uk/1/hi/health/1039426.stm

--------------------------------------------------------

Aging: impact upon local cerebral oxygenation and blood flow with acute
isovolemic hemodilution.
Li M, Ratcliffe SJ, Knoll F, Wu J, Ances B, Mardini W, Floyd TF
J Neurosurg Anesthesiol. 2006 Apr ; 18(2): 125-31

Data from the neurosurgical critical care arena demonstrate a
correlation between cerebral oxygenation, survival, and cognitive
function. Transfusion may increase and hemodilution decrease cerebral
oxygenation. Both acute and chronic anemia have been associated with
cognitive dysfunction. Aggressive blood conservation protocols have
been instituted across all age groups without conclusive evidence for
their impact upon outcome. Aged subjects are at the greatest risk of
cognitive sequelae after major surgery associated with significant
blood loss. We hypothesize that cerebral physiologic changes associated
with "normal" aging may compromise cerebral oxygenation in the presence
of severe anemia.Fischer 344 rats, the NIH National Institute of Aging
normal aging rat model, underwent a stepwise isovolemic hemodilution
protocol. Age groups (Age Grp) studied were as follows: Age Grp-A (3
months), n=14; Age Grp-B (9 to 12 months), n=14; and Age Grp-C (24
months), n=14. Brain oxygen tension (PBrO2), laser Doppler flow, and
mean arterial pressure were measured. Final hemoglobin averaged
6.1+/-0.9 g/dL. PBrO2 levels decreased from a baseline of 18.1+/-4.1 to
17.5+/-6.8 mm Hg (P=0.49), and laser Doppler flow increased by 18+/-20%
(P<0.0001) after hemodilution. Employing repeated measures multiple
regression, Age Grp (P=0.30) was not a significant controlling
covariate of PBrO2 in response to isovolemic hemodilution. PBrO2 levels
were actually higher in Age Grp-C animals at all time points of the
hemodilution protocol, although this was not statistically significant.
Aged animals were also fully capable of mounting a robust local
cerebral hyperemic response to the anemic challenge that was not
separable from the response of younger animals.

---------------------------------------------------------------------------

The effects of perioperative blood transfusion on morbidity and
mortality after esophagectomy.
Fields RC, Meyers BF
Thorac Surg Clin. 2006 Feb ; 16(1): 75-86

The effect of blood transfusion on outcomes in esophageal surgery
remains controversial. The contrasting conclusions drawn from a number
of retrospective analyses with different methodologies create a
landscape that is difficult to interpret. Because of the scope of
esophageal resection, the need for blood transfusion cannot be
eliminated. What recommendations then, if any, can be made for the
practicing surgeon? First, surgeons and anesthesiologists need to
reevaluate their transfusion thresholds. The age-old practice of
keeping the hemoglobin above 10 g/dL has very little evidence-based
support. A multicenter, randomized, controlled clinical trial in Canada

demonstrated that a restrictive strategy of blood transfusion, in which

patients were transfused only for a hemoglobin level of less than 7
g/dL, was at least as effective as and possibly was superior to a
liberal transfusion strategy in critically ill patients. It has also
been estimated that more than 25% of patients undergoing colorectal
resections may receive at least one unit of unnecessary blood. Further,

the immediate reduction in the hemoglobin concentration caused by the
normovolemic hemodilution associated with surgery and crystalloid fluid

replacement is not associated with any increased morbidity or
mortality. If these data are examined in the context of the results of
Langley and Tachibana indicating that a threshold amount of blood needs

to be transfused to impact outcomes, it becomes even more important to
limit transfusion to only the amount that is essential. Thus, surgeons
and anesthesiologists should adopt a more stringent set of requirements

for blood transfusion. Second, with the proven feasibility and
reduction in infectious complications associated with autologous
blood-donation programs, any patient who meets the criteria discussed
here should be encouraged to participate in such a program. Although
the effect of autologous blood on cancer outcomes remains unclear, the
other advantages certainly make such a program worthy of consideration.

This discussion leads to a final point, namely that patients should be
encouraged, whenever possible, to participate in clinical trial
research. The only way that the community of surgeons treating patients

who have esophageal cancer can hope to address properly the question of

how blood transfusion affects outcomes is with well-designed clinical
trials. A large, multicenter, randomized trial (level I) would be
ideal. Short of such a trial, inclusion criteria and study methodology
should be discussed among various institutions to avoid the differences

in studies that make direct comparisons of results among different
investigators difficult and potentially meaningless. This measure would

at least allow different level II to IV data to be compared directly
with some validity.

----------------------------------------------------------------

Sooooo .. according to these studies .. hemoglobin CANNOT / should NOT
... be used in ANY .. blood work .. as ANYTHING .. unless it is below at
least .. 7.

--------------------------------------------------

Therefore rendering the .. 75% of the iron deficient world .. HEALED ..

Heh .. heh ..

"I am more than man , more than life ! I am a GOD ! "

Isn't .. that .. right ..

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com

Man Is A Herbivore!
http://tinyurl.com/a3cc3

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk

babawali.com

2006-06-04, 9:21 am

Ah, what did the body do all these million years before these tests came
along and showed its fine tuned regulation of such levels was all wrong?
This is what happens when someone tries to connect the dots using a spray
gun.

Huh?

2006-06-04, 9:21 am

Stuart Hyderman very gifted and talented Chiropractor, researcher and
clinician
<ironjustice@aol.com> wrote in message
news:1148409157.353734.301180@g10g2000cwb.googlegroups.com...
> In the mouse .. model .. a hemoglobin of 6 .. doesn't seem to .. bother
> .. it .. a .. bit ..
> ------------------------------------------------------------------
>
> A reduction of hemoglobin concentration to a subnormal level increased
> oxygen consumption without lowering oxygen delivery.
>
> http://tinyurl.com/2zffh
> ------------------------------------------------------
>
> This might / would go right along with the runners PARADOX of a
> hemoglobin .. COMMONLY .. of .. 9 .. http://tinyurl.com/jvvu7
>
> and the hemoglobin of pregnant women who TEND TO HAVE LIVE BIRTHS..
> http://news.bbc.co.uk/1/hi/health/1039426.stm
>
>
> --------------------------------------------------------
>
> Aging: impact upon local cerebral oxygenation and blood flow with acute
> isovolemic hemodilution.
> Li M, Ratcliffe SJ, Knoll F, Wu J, Ances B, Mardini W, Floyd TF
> J Neurosurg Anesthesiol. 2006 Apr ; 18(2): 125-31
>
> Data from the neurosurgical critical care arena demonstrate a
> correlation between cerebral oxygenation, survival, and cognitive
> function. Transfusion may increase and hemodilution decrease cerebral
> oxygenation. Both acute and chronic anemia have been associated with
> cognitive dysfunction. Aggressive blood conservation protocols have
> been instituted across all age groups without conclusive evidence for
> their impact upon outcome. Aged subjects are at the greatest risk of
> cognitive sequelae after major surgery associated with significant
> blood loss. We hypothesize that cerebral physiologic changes associated
> with "normal" aging may compromise cerebral oxygenation in the presence
> of severe anemia.Fischer 344 rats, the NIH National Institute of Aging
> normal aging rat model, underwent a stepwise isovolemic hemodilution
> protocol. Age groups (Age Grp) studied were as follows: Age Grp-A (3
> months), n=14; Age Grp-B (9 to 12 months), n=14; and Age Grp-C (24
> months), n=14. Brain oxygen tension (PBrO2), laser Doppler flow, and
> mean arterial pressure were measured. Final hemoglobin averaged
> 6.1+/-0.9 g/dL. PBrO2 levels decreased from a baseline of 18.1+/-4.1 to
> 17.5+/-6.8 mm Hg (P=0.49), and laser Doppler flow increased by 18+/-20%
> (P<0.0001) after hemodilution. Employing repeated measures multiple
> regression, Age Grp (P=0.30) was not a significant controlling
> covariate of PBrO2 in response to isovolemic hemodilution. PBrO2 levels
> were actually higher in Age Grp-C animals at all time points of the
> hemodilution protocol, although this was not statistically significant.
> Aged animals were also fully capable of mounting a robust local
> cerebral hyperemic response to the anemic challenge that was not
> separable from the response of younger animals.
>
> --------------------------------------------------------------------------
-
>
> The effects of perioperative blood transfusion on morbidity and
> mortality after esophagectomy.
> Fields RC, Meyers BF
> Thorac Surg Clin. 2006 Feb ; 16(1): 75-86
>
> The effect of blood transfusion on outcomes in esophageal surgery
> remains controversial. The contrasting conclusions drawn from a number
> of retrospective analyses with different methodologies create a
> landscape that is difficult to interpret. Because of the scope of
> esophageal resection, the need for blood transfusion cannot be
> eliminated. What recommendations then, if any, can be made for the
> practicing surgeon? First, surgeons and anesthesiologists need to
> reevaluate their transfusion thresholds. The age-old practice of
> keeping the hemoglobin above 10 g/dL has very little evidence-based
> support. A multicenter, randomized, controlled clinical trial in Canada
>
> demonstrated that a restrictive strategy of blood transfusion, in which
>
> patients were transfused only for a hemoglobin level of less than 7
> g/dL, was at least as effective as and possibly was superior to a
> liberal transfusion strategy in critically ill patients. It has also
> been estimated that more than 25% of patients undergoing colorectal
> resections may receive at least one unit of unnecessary blood. Further,
>
> the immediate reduction in the hemoglobin concentration caused by the
> normovolemic hemodilution associated with surgery and crystalloid fluid
>
> replacement is not associated with any increased morbidity or
> mortality. If these data are examined in the context of the results of
> Langley and Tachibana indicating that a threshold amount of blood needs
>
> to be transfused to impact outcomes, it becomes even more important to
> limit transfusion to only the amount that is essential. Thus, surgeons
> and anesthesiologists should adopt a more stringent set of requirements
>
> for blood transfusion. Second, with the proven feasibility and
> reduction in infectious complications associated with autologous
> blood-donation programs, any patient who meets the criteria discussed
> here should be encouraged to participate in such a program. Although
> the effect of autologous blood on cancer outcomes remains unclear, the
> other advantages certainly make such a program worthy of consideration.
>
> This discussion leads to a final point, namely that patients should be
> encouraged, whenever possible, to participate in clinical trial
> research. The only way that the community of surgeons treating patients
>
> who have esophageal cancer can hope to address properly the question of
>
> how blood transfusion affects outcomes is with well-designed clinical
> trials. A large, multicenter, randomized trial (level I) would be
> ideal. Short of such a trial, inclusion criteria and study methodology
> should be discussed among various institutions to avoid the differences
>
> in studies that make direct comparisons of results among different
> investigators difficult and potentially meaningless. This measure would
>
> at least allow different level II to IV data to be compared directly
> with some validity.
>
> ----------------------------------------------------------------
>
> Sooooo .. according to these studies .. hemoglobin CANNOT / should NOT
> .. be used in ANY .. blood work .. as ANYTHING .. unless it is below at
> least .. 7.
>
> --------------------------------------------------
>
> Therefore rendering the .. 75% of the iron deficient world .. HEALED ..
>
>
> Heh .. heh ..
>
> "I am more than man , more than life ! I am a GOD ! "
>
> Isn't .. that .. right ..
>
> Who loves ya.
> Tom
>
>
> Jesus Was A Vegetarian!
> http://jesuswasavegetarian.7h.com
>
>
> Man Is A Herbivore!
> http://tinyurl.com/a3cc3
>
>
> DEAD PEOPLE WALKING
> http://tinyurl.com/zk9fk
>