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Banked Blood May Not Be As Effective As Hoped

kdawson posted more than 6 years ago | from the round-up-the-usual-vampires dept.

Biotech 116

URSpider alerts us to two separate research reports published in the Proceedings of the National Academy of Sciences pointing to the rapid breakdown of nitric oxide in donated blood as a reason why such blood loses its ability to transfer oxygen, and is sometime implicated in problems such as strokes and heart attacks. Nitric oxide depletion is significant after 3 hours of storage; yet current guidelines allow for storing donated blood for up to 42 days. The article notes: "Several of the researchers, including Stamler, have consulting and/or equity relationships with Nitrox/N30, a company developing nitric oxide based therapies."

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116 comments

pros and cons (5, Insightful)

LiquidCoooled (634315) | more than 6 years ago | (#20917647)

Let me weigh up the situation here:

Die due to running out of blood.
Survive because someone donated blood.

I realise that the length of time is a factor and you want the freshest possible, but beggars can't be choosers.

Re:pros and cons (3, Insightful)

AusIV (950840) | more than 6 years ago | (#20917699)

Not only that, we've been transfusing blood for decades. If guidelines allow for storing blood up to 42 days, and people survive after being given 41 day old blood, I fail to see why the requirements should be changed.

Re:pros and cons (1)

cyphercell (843398) | more than 6 years ago | (#20917787)

I'm just guessing here (didn't rtfa), but it seems like some people might be affected by the discrepancy while others aren't. Kinda like how some people are allergic to bees and we still try to help them, even though Most people don't have a problem.

Re:pros and cons (5, Informative)

nursegirl (914509) | more than 6 years ago | (#20918019)

The problem listed in the article is an increase in heart attacks and strokes post-transfusion. Time's more complete article [time.com] says that 25% of blood donor recipients have heart attacks within the 30 days post-transfusion, as opposed to 8% of patients who came in to the emergency with similar conditions, but did not get a blood transfusion.

When the problem shows itself over the 30 days post-transfusion, it can be hard for medical researchers to notice and research the issue. I'd suggest (assuming this research has been done properly), having my probability of MI increase from less than 1 in 10 to 1 in 4, would make me want them to consider altering the requirements, whether it be by providing more new blood, or by artificially adding Nitric Oxide (not Nitrous Oxide, as the summary claims).

Re:pros and cons (2, Insightful)

stapedium (228055) | more than 6 years ago | (#20918655)

Yes but did they control for the reason the people received a transfusion. Its not like the ER just gives everyone that walks through the door with chest pain a transfusion. There is an underlying reason for each of those transfusions that probably made them at higher risk for stroke or and MI (things like being on blood thinners because of previous heart attacks, blood clots, or strokes).

I would guess that people who received blood transfusions are also at higher risk for pneumonia and cancer.

And if NO would fix all this, they should just give them generic oral nitrates, not some crazy system to add NO to banked blood.

Re:pros and cons (2, Interesting)

nursegirl (914509) | more than 6 years ago | (#20919079)

From Time:

The trend affects almost every group of critically ill patients -- from trauma sufferers in the ER to heart attack victims, patients with anemia and those undergoing chemotherapy. ... "After you control for sickness and all sorts of things, patients who receive transfusions still have more heart attacks. It makes no sense," says Dr. Jonathan Stamler, a professor of medicine at Duke University Medical Center.
It'll be interesting to see whether the research proves that oral nitrates will be effective. The Time article mentioned that mouse studies have shown that adding NO to blood given to mice reduces their likelihood of cardiac complications. I haven't been able to get at the original journal article yet, though.

NO dilates blood vessel and not always desired. (5, Informative)

DrYak (748999) | more than 6 years ago | (#20919555)

Nitric Oxide (NO, not NO2 or N2O) [wikipedia.org] is a small molecule that is used by the body as a messenger that causes blood vessels to dilate. It is a messenger that is naturally produced by the body.

In natural circumstance, for exemple, it is produced during effort to divert blood to region where it is needed (because the adrenaline has a global effect of closing the blood vessels).
In medicine, products that create NO like Nitroglycerin are used to dilate vessels and increase blood flow to the heart in case of angor (not enough blood in the heart muscle because of cholestrerol-clogged arteries).
Sildenafil (Viagra) is an inhibitor which stops the destruction of NO, thus maintaining enough level of NO, so the vessels are dilate and there's enough blood flow to fill the penis and provide erection.

Yes, if there's not enough NO, a stroke may appear. That's why Nitro-glycerine is given to avoid it.
Yes, transfused blood is more dense than other substance that can be injected to compsensate blood loss (other substance = Ringer solution = physiological serum = basically isotonic sterile salty water with some additional sugar thrown in). And this increased viscosity may increase the risk of stroke.

Now, just concentrate for a moment : to whom are you going to transfuse blood / perfuse physiological serum ?
People who lost a lot of liquid (bleeding wounds, burns, etc.).
Why ?
Because their blood pressure is dropping and there is a risk of shock (= schematically, not enough blood pressure to irrigate brain and other important organs).
Now, all /. (not only medical geeks, but also people who watch medical shows like ER and House. Not Grey's Anatomy) know that, in those circumstance, dilating the blood vessels by adding NO is the last thing you want to do, because the dilatation will drop the blood pressure again. In fact what you give those people is adrenaline, which *contracts* the vessels, and cause the pressure the rise back to the normal. But as said before, contraction increase the risk of not enough blood flow in the coronary arteries, thus risk of stroke.

Now to go back to the situation, all the people from the study cited by the Times had (supposedly - didn't read the actual study yet) low blood pressure. Some got blood transfusion, other did not (I suppose they recieved physiological solutions instead).

25% of the blood reciever had heart attacks.
It may be caused, as the sponsor would like us to believe (the company makes NO products), because NO binds to hemoglobine [wikipedia.org] and helps releasing oxygen. And thus the transfused blood was useless because it didn't have enough NO to release enough oxygen. In this case we should buy the company's NO products.
BUT :
- Why didn't the physiological receiving patient had problems ? Physiological serum doesn't carry oxygen at all. If NO-less blood is useless at transporting oxygen, non-oxygen-transporting solutions should too...
- Where they compared against a 3rd group receiving only fresh (NO-rich) blood ? No. Where they compared against 4th group receiving NO enriched non-fresh blood ? No, this was only done in lab rats.
- NO is something produced by the body when needed and has a short life (3 hours as they said in stored sample). Presence or absence of NO in the blood can hardly explain stroke happening 30 days later, after 3 hours the NO contained in the transfused blood is already degraded and replaced by NO produced by the patient.
- Other ligands can also increase release of O2 : temperature, CO2, products of degradation of glucose. Hemoglobine has a lot of different way to guess that some body regions are burning a lot of oxygen and that the hemoglobin-bound oxygen should be released more easily.
- Also note that their explanation can only account for the brain hypoxia (lack of oxygen), not the stroke itself (clogged vessels).

On the other hand, if we stop listening the merchant trying to push their product :
The stroke may be due of the increased viscosity in patient blood, because what is injected are only red cells.
- That would explain the stroke.
- Doctors now follow new directives asking to transfuse blood only when the initial hematocrite is very low. They replenish lost volume with blood cells only when there *really* not enough hemoglobine. Data on patient tend to show good results.
- This hypothesis could produce similar results (25% vs 8% stroke).

Also note that :
- The increased blood viscosity is one of the measure used to discover abusive blood transfusion in cheating athletes.
- Stroke is the main health risk because of which abusive transfusion is forbidden in athletes.

For me, the whole article seems PR from a company trying to find a new way to sell it's NO products.

Re:NO dilates blood vessel and not always desired. (0, Redundant)

Eivind Eklund (5161) | more than 6 years ago | (#20922939)

Very nice post. Thanks.

Re:pros and cons (2, Informative)

nbritton (823086) | more than 6 years ago | (#20920175)

Take some low dose, enteric-coated, aspirin if your worried about your blood clotting after a transfusion.

Re:pros and cons (2, Funny)

TapeCutter (624760) | more than 6 years ago | (#20921577)

A big fat joint will do the same trick - with hilarious side effects.

Re:pros and cons (1)

slater86 (1154729) | more than 6 years ago | (#20920603)

I have heard of people living a health life after having a heart attack but i've never heard of people living a healthly life after being dead (e.g.lack of blood and all).

I think i'd prefer the heart attack thanks.

Re:pros and cons (2, Interesting)

sjames (1099) | more than 6 years ago | (#20922715)

ays that 25% of blood donor recipients have heart attacks within the 30 days post-transfusion, as opposed to 8% of patients who came in to the emergency with similar conditions, but did not get a blood transfusion.

First, those figures apply only to heart disease patients, so are likely on the edge anyway. The stats presented do need to be looked at, but there can be many reasons for the differences that have nothing to do with NO levels. For example, increasing the blood viscosity (by adding red blood cells) can strain the heart.

It could be flaws in the study. For example, patients who need blood to improve oxygenation have been inadequately oxygenated before. That may be the root cause.

Alternatively, if it IS the NO levels, nitroglycerine is dirt cheap in comparison to any new drug and may be just as effective.

We won't actually know until double blind studies are done.

Re:pros and cons (1)

fractoid (1076465) | more than 6 years ago | (#20922865)

Alternatively, if it IS the NO levels, nitroglycerine is dirt cheap in comparison to any new drug and may be just as effective.
Nitroglycerine? Just make sure not to chew the tablet, and DEFINITELY don't exercise for half an hour afterwards!

Re:pros and cons (0)

Anonymous Coward | more than 6 years ago | (#20918091)


Not only that, we've been transfusing blood for decades. If guidelines allow for storing blood up to 42 days, and people survive after being given 41 day old blood, I fail to see why the requirements should be changed.


Perhaps because a close look at the data has recently been done, and it seems to show that under certain circumstances receiving a blood transfusion actually lowers your chance of survival.

Does that mean that blood is bad? Of course not. It means the "blood is good for 41 days" standard is probably not sufficient. We need to understand the circumstances where blood transfusions are helpful and where they are not. The result will be a new standard that takes the new information into account and results in a higher overall survival rate than we have today.

What's up with the "It was good enough for our forefathers, so we must not consider whether it is correct and complete?"

Re:pros and cons (4, Insightful)

Vellmont (569020) | more than 6 years ago | (#20917779)


Let me weigh up the situation here:

Die due to running out of blood.
Survive because someone donated blood.


Or the third possibility, which this article is likely addressing:

Receive a nitric oxide injection that's packaged along with the blood in addition to the blood transfusion, and have an even better chance of surviving than blood alone.

Why do you think there's only two possibilities?

Re:pros and cons (1)

perlchild (582235) | more than 6 years ago | (#20917899)

He didn't read the summary, it was in there with the comment about Nitrox and the article having potential for bias.

Re:pros and cons (3, Insightful)

virtualXTC (609488) | more than 6 years ago | (#20918135)

I imagine the company being consulted (being a nitric oxide vendor) would is actually pushing for the blood be infused with nitric oxide.
I don't see injections of nitric oxide being pushed as, the nitric oxide pathway is the same one that Viagra works on.

Re:libs and cons (1)

IthnkImParanoid (410494) | more than 6 years ago | (#20918787)

Why do you think there's only two possibilities?
Clearly the first possibility is the conservative policy, because we shouldn't be playing god with people's blood. The second possibility is the liberal policy, because we get medical treatment, but it's substandard and poorly thought out. There may be a third possibility, but hippies throwing away their vote on it is pointless and will just help fascist hospital administrators suspend our rights to Healthius Corpus altogether.

Re:libs and cons (0)

Anonymous Coward | more than 6 years ago | (#20919987)

That got a chuckle from me.

Re:pros and cons (0)

Anonymous Coward | more than 6 years ago | (#20921945)

Why do you think there's only two possibilities?


Because he is either with us or he is with the terrorists. duh

Re:pros and cons (4, Insightful)

nursegirl (914509) | more than 6 years ago | (#20917847)

Actually, the situation is closer to:

1) Potentially die due to running out of blood (although many blood recipients aren't at death's door when they receive transfusions)
2) Potentially die post-transfusion from a heart attack or stroke
3) Potentially receive added nitric oxide, once study of this matter has moved forwards.

Shouldn't the goal of medical research be that we don't have medical beggars, but instead that anyone can have the best possible options?

Re:pros and cons (1)

njfuzzy (734116) | more than 6 years ago | (#20917971)

I think the point is more, how to we make the survival rate even better. Not every problem means chosing to avoid a solution.

Re:pros and cons (1)

xanthines-R-yummy (635710) | more than 6 years ago | (#20920117)

I believe the phrase "The enemy of good is better" comes to mind right about now...

Re:pros and cons (3, Interesting)

Chris Burke (6130) | more than 6 years ago | (#20918627)

Already hospitals prefer to use fresh blood in transfusions, and when they can predict the need they get fresh blood when possible. I myself have been called by the local Blood & Tissue Center to donate blood for a child's operation that was going to be performed the next day. It wasn't a general supply issue; my blood type is A+, the second most common in the U.S. and when I asked they said they had plenty. It's just that since they knew of the need in advance they could afford to take the time to call me up for some of my fresh blood.

If the results of this study bear out, then it may just mean that hospitals are even more likely to try to get a fresh donation prior to any surgery that may require a transfusion. E.R. is still going to have to deal with whatever supply they have on hand when someone comes through the doors, though maybe there are procedural changes they can make to help ensure that they use newer blood by preference?

Re:pros and cons (0)

Anonymous Coward | more than 6 years ago | (#20919973)

It saved my life. I would be dead as of March 2, 2006 if not for donated blood.

Oh, and the surgeon who took out my perforated colon, that was a big help too.

But my point is, I didn't ask how fresh the blood was, I just said "mbluwahhh fborrrgh" or similar, which they took to mean "I consent".

no huhu (3, Funny)

stoolpigeon (454276) | more than 6 years ago | (#20917671)

just keep these handy [hawkinsspeedshop.com] in the operating rooms.

Queue the Laughing Gas Jokes.... (0)

Anonymous Coward | more than 6 years ago | (#20917681)

Damn I just needed to add blood to the air intake!

WARNING - May be Dug Company Propaganda! (5, Informative)

jimwelch (309748) | more than 6 years ago | (#20917693)

As point out in the article, the study was funded by a company that makes a "drug" to fix this!

But Wait, There's More! (1)

R2.0 (532027) | more than 6 years ago | (#20918295)

"This is an important observation and it needs to be followed up," said Dr. Louis Katz, a past president of America's Blood Centers, which provides about half the nation's blood."

Not exactly. From America's Blood Center's website profile:
"Founded in 1962, America's Blood Centers (ABC) is North America's largest network of non-profit, community blood centers."

Note the word "network". They are a trade organization - "America's Blood Centers" doesn't "provide" blood products - their members do.

The largest "provider" of blood and blood products is the American Red Cross, with about 40% of the market (cue "ARC is evil" comments". After that is United Blood Services, with about 10%, I think. Then it's a whole bunch of regional blood banks, each with a very small market share.

Regardless of who said what to whom, there is never enough blood in the system for more than a few days.

GIVE BLOOD!

Re:But Wait, There's More! (1)

phorm (591458) | more than 6 years ago | (#20918709)

Note the word "network". They are a trade organization - "America's Blood Centers" doesn't "provide" blood products - their members do

An organization is often representative of its members. See RIAA, MPAA

Not that this study shouldn't bear some thought, but it perhaps take it with a grain of salt.

Re:But Wait, There's More! (1)

PCM2 (4486) | more than 6 years ago | (#20919133)

Regardless of who said what to whom, there is never enough blood in the system for more than a few days.
Indeed. I am blood type O+. This is one of the most common types of blood. One might conclude, then, that I don't need to worry so much about giving blood, because there's plenty of it out there. But that's flawed logic; if more people in the world have type O+ and car accidents (for example) are randomly distributed across the entire population, then it stands to reason that type O+ blood is in much greater demand than other, rarer types. And, indeed, my local blood bank informs me that it regularly experiences severe shortages of type O+ blood (as in, "two pints left"). I try to donate regularly.

I don't think that's reliable (1)

Rix (54095) | more than 6 years ago | (#20919471)

I'm sure your local blood bank would say exactly the same thing regardless of what type you were asking after.

Re:But Wait, There's More! (1)

petermgreen (876956) | more than 6 years ago | (#20919617)

IINAD but I belive what is really in demand is O- because it is what they give patients who need blood ASAP and who are of unknown blood group.

IIRC O+ can be given to anyone with a positive blood group so if A+ or B+ runs out they can use O+ but if O+ runs out they can't use A+ or B+.

Don't you find it rather creepy... (1)

Rix (54095) | more than 6 years ago | (#20919189)

To sell blood? I fully support giving blood, but what's the point if it's just going to be sold at a profit? I'm not in the habit of giving charitable donations to corporations.

Re:But Wait, There's More! (1)

CheshireCatCO (185193) | more than 6 years ago | (#20920817)

Er, I think grandparent was referring to

Several of the researchers, including Stamler, have consulting and/or equity relationships with Nitrox/N30, a company developing nitric oxide based therapies.
The research might very well be 100% valid, but that's not something that instills confidence that they're unbiased.

Re:WARNING - May be Dug Company Propaganda! (1)

kripkenstein (913150) | more than 6 years ago | (#20922981)

the study was funded by a company that makes a "drug" to fix this!
Drug, shmug. The aliens from "V" were right - the only way to get blood is fresh blood.

Easy Solution! (0)

Anonymous Coward | more than 6 years ago | (#20917715)

Free whippets for all blood donors! WHOOOOOOOOOOOOOO

Re:Easy Solution! (2, Funny)

Boogaroo (604901) | more than 6 years ago | (#20917811)

Free whippets for all blood donors! WHOOOOOOOOOOOOOO
I'm sure you may be a fan of these, [akc.org] but please don't contribute to the pet population problem. ;)

Re:Easy Solution! (1)

JohnnyGTO (102952) | more than 6 years ago | (#20918407)

Brother had a friend that loved those things, now he just drools a lot. Sad.

Re:Easy Solution! (1)

Some_Llama (763766) | more than 6 years ago | (#20918681)

I had a friend who loved those things and suffered no ill effects at all. right back at ya.

Re:Easy Solution! (1)

gold23 (44621) | more than 6 years ago | (#20918763)

I've heard about dogs and their owners becoming slowly more like each other over time, but that's ridiculous!

Got a lot to learn (-1, Flamebait)

EmbeddedJanitor (597831) | more than 6 years ago | (#20917723)

When you read stuff like this, it makes you realise how much we still have to learn. Blood transfusion is over 500 years old and we still don't understand it properly.

Makes you realise that all the "scientists predict.. [insert global warming/oil crisis/ cancer cure/...]" is just pissing in the wind.

Re:Got a lot to learn (4, Informative)

guruevi (827432) | more than 6 years ago | (#20918059)

Successful blood transfusion has only been around for ~100 years. Before that there were attempts with usually deadly results and the practice to let your blood run out was practiced on a regular basis.

Even now, blood transfusions are only used by doctors in the most critical situation and yes, storage and transfer of blood as well as the necessary screenings make it very difficult to get a 1) cheap and 2) reliable source of blood.

Some doctors even don't use blood transfusions at all (there are even some hospitals that don't give any blood for any reason) and use substitutes like volume expanders or oxygen carriers to get what the body needs (either a larger volume of blood or more carriers so a subject doesn't asphyxiate) or they use only parts of the blood that are deemed necessary (for example to clot your blood faster) and that are more safe than blood.

Blood is considered an organ, with transfusions you get issues like rejection just like you get (often) with liver transplants and giving somebody a large amount of foreign blood could also result in shock or death.

Re:Got a lot to learn (1)

fain0v (257098) | more than 6 years ago | (#20918073)

You are correct. We don't know one tenth of one percent about anything. That means we should just ignore everything that we do know until we know everything.

Re:Got a lot to learn (1)

dslauson (914147) | more than 6 years ago | (#20918115)

Oh, come on, man. Do you have any ideas how many lives have been saved from blood transfusions? They are VERY effective. This article is pointing out that they could be MORE effective.

Taking this article to mean that all science is bullshit is a pretty fucking big leap. I guess what I'm saying is, you're an idiot.

Re:Got a lot to learn (0)

Anonymous Coward | more than 6 years ago | (#20918169)

I think you mean pissing in the Category 4 hurricane.

You have a point though, science in the macro is never as well-defined as science in the micro.

Re:Got a lot to learn (2, Insightful)

moderatorrater (1095745) | more than 6 years ago | (#20918191)

I agree with the beginning of your post, but not the conclusion. Yes, we've been messing with blood transfusions for centuries, but in that time we've learned about blood types (thus explaining the mysterious deaths of a large portion of those receiving transfusions), learned to test for diseases, store and maintain blood supplies, and have the donation down to a system where I can do it at lunch and go back to work. Now, we may even be able to do a hybrid of synthetic/natural blood that's more effective than the stored blood would be otherwise; that's quite a feat.

Your concluding that scientists are just pissing in the wind is like concluding that car manufacturers are just pissing in the wind because of the recent invention of heated seats.

Blood doping? (3, Insightful)

drunken_boxer777 (985820) | more than 6 years ago | (#20917731)

So am I to believe that all of a sudden blood doping isn't as effective either?

Perhaps the blood is not as efficient as it could be in transferring oxygen, but I would think that it is still pretty damn useful.

NO, pills and even some blood doping info (2, Informative)

gnuman99 (746007) | more than 6 years ago | (#20919921)

Nitric Oxide is a vasodilator (causes your blood vessels to expand). Thus if you get a blood transfusions and you have a potential of getting a heart attack or stroke from blocked arteries before the transplant (atherosclerosis for example), your blood vessels will constrict and you may crap out. As always, karma link to wikipedia on this

http://en.wikipedia.org/wiki/Endothelium-derived_relaxing_factor [wikipedia.org]

There are ways of going around this, like taking nitroglycerin pills

http://en.wikipedia.org/wiki/Glyceryl_trinitrate_(pharmacology) [wikipedia.org]

Blood doping works. But problem is that viscosity increases and you can crap out. Essentially, blood doping is putting a huge strain on your circulatory system so that there is a little more gas in the tank. Really bad idea. Just like taking steroids. You can crap out anytime.

I don't want to be a naysayer, but... (1)

CyberLord Seven (525173) | more than 6 years ago | (#20917757)

Several of the researchers, including Stamler, have consulting and/or equity relationships with Nitrox/N30, a company developing nitric oxide based therapies.
I only post this because I have heard so much over the decades about how blood transfusions have saved lives. Now I read this and have to wonder. My skepticism is tempered, but still present.

Re:I don't want to be a naysayer, but... (0, Troll)

Mattintosh (758112) | more than 6 years ago | (#20917937)

Little known fact: the first blood transfusion was a complete and utter failure.

It was for one of the popes, and they drew blood from 3 young boys and fed it to the pope. Yes, fed it to him. The pope died, since he simply digested the blood rather than being able to use it as blood. The boys... well... they died from infections from being bled out to feed a dying pope their blood.

Great story, huh? Death by bleeding and infection: It makes pedophilic anal rape seem like nothing in comparison. Gotta love those crazy pseudo-christians. The funny thing is, if they were really doing things the christian way, they wouldn't be having blood transfusions in any form at all. "Abstain from blood" and all that, you know...

Re:I don't want to be a naysayer, but... (1)

Maxo-Texas (864189) | more than 6 years ago | (#20919069)

Multiple Sources...Looks to be true tho the church disputes it.

http://en.wikipedia.org/wiki/Blood_transfusion [wikipedia.org]

Early attempts

The first historical attempt at blood transfusion was described by the 15th-century chronicler Stefano Infessura. Infessura relates that, in 1492, as Pope Innocent VIII sank into a coma, the blood of three boys was infused into the dying pontiff (through the mouth, as the concept of circulation and methods for intravenous access did not exist at that time) at the suggestion of a physician. The boys were ten years old, and had been promised a ducat each. However, not only the pope died, but so did the three children. Some authors have discredited Infessura's account, accusing him of anti-papalism.

http://www.anes.uab.edu/july.htm [uab.edu]
1492 July 25: Giovanni Battista Cibo, born in Genoa, Italy, in 1432, dies. On August 29, 1484, he became Pope Innocent VIII. An early attempt at blood transfusion involving Pope Innocent VIII was described by Stefano Infessura [ca. 1435-1500], an anti-papist lawyer in Rome. According to Infessura's Diary of the City of Rome, when the Pope was on his deathbed, a Jewish physician suggested infusing blood from three ten year-old boys into the pontiff's veins. All three donors died and Innocent himself died on July 25, 1492. The Catholic Encyclopedia warns that Infessura's work is full of gossip and not to be trusted.

Re:I don't want to be a naysayer, but... (1)

fastest fascist (1086001) | more than 6 years ago | (#20919229)

What do you mean, multiple sources? Both quotes point to one source, Stefano Infessura.

And of course, it was a jewish doctor... (1)

tjstork (137384) | more than 6 years ago | (#20922135)

that killed the pope. Sounds like our guy not only had an anti-papist agenda, but didn't like jews either.

Donated blood works, just not as well (1)

spineboy (22918) | more than 6 years ago | (#20918519)

It works great, but just not as well as your own blood. When administered, you will see a persons heart rate decrease if they are tachycardic(fast heart rate) from a low hemoglobin (blood count). The blood definitely does work, but probably only 60-80% as effective as regular blood.

Re:I don't want to be a naysayer, but... (1)

PCM2 (4486) | more than 6 years ago | (#20919175)

I only post this because I have heard so much over the decades about how blood transfusions have saved lives. Now I read this and have to wonder.

I don't get it. What is it about this brand-new proposed therapy that makes you suspect that the therapy that has been used for years and years does not save lives?

If blood transfusions don't save lives, then what the hell else has kept all those people alive? Were they just mutants who didn't need as much blood as you or I?

Wrong Chemical in summary (5, Informative)

travisd (35242) | more than 6 years ago | (#20917761)

The article is referring to Nitric Oxide - NO -- not Nitrous Oxide - N2O

Re:Wrong Chemical in summary (1)

Seakip18 (1106315) | more than 6 years ago | (#20917841)

Yep. That'd be something different. Maybe that's the excuse for the editing?

Re:Wrong Chemical in summary (1)

Neanderthal Ninny (1153369) | more than 6 years ago | (#20918005)

You are correct. Maybe they are mixing up nitrous oxide for the dentist or dragsters and the nitric oxide in this story. In any case this study is funded by this company and the school so I would like to have a peer review and experiments from 3rd parties we can make sure these results aren't skewed.

Re:Wrong Chemical in summary (1)

Dogtanian (588974) | more than 6 years ago | (#20918047)

The article is referring to Nitric Oxide - NO -- not Nitrous Oxide - N2O
I was going to mod this up funny- then I wondered what I was laughing at and realised that the nurses had plugged me in to the wrong gas cylinder.

I hope they got it right the second time around- let me check. Nitrogen Dioxide? That doesn't sound right... nurse! Nurse! Nu

NO CARRIER

Re:Wrong Chemical in summary (1)

necro81 (917438) | more than 6 years ago | (#20918493)

The article is referring to Nitric Oxide - NO -- not Nitrous Oxide - N2O
Quite right. The difference is pretty important.

Nitric Oxide is used to improve perfusion in people on respirators. It is particularly useful in premature babies in the NICU [google.com] , whose lungs are not as well developed and have difficulty absorbing enough oxygen and can suffer from pulmonary hypertension. In general, NO relaxes the smooth muscle in arteries, making it a vasodilator. It is rapidly absorbed and deactivated by hemoglobin, so it's effects are generally confined to the lungs (i.e., they're not systemic). So, while the research may be biased by a company that wants to sell something, there is at least some science behind it.

Nitrous Oxide is laughing gas, an anesthetic. It can also cause various psychological effects. It isn't metabolized quickly in the body, such that a person breathing it in can also breathe it out. In small doses it can cause euphoria. In higher doses it can cause various psychoses and death through hypoxia.

Re:Wrong Chemical in summary (1)

twoallbeefpatties (615632) | more than 6 years ago | (#20919025)

I can only imagine that giving a guy a nitrous oxide injection would result in... well, ever play Bioshock?

Laughter is the best medicine.... (1)

EmbeddedJanitor (597831) | more than 6 years ago | (#20920191)

.... err, maybe not!

Isaac Asimov died of AIDS. (-1, Flamebait)

Anonymous Coward | more than 6 years ago | (#20917821)

Blood banks are scary crocks.

Re:Isaac Asimov died of AIDS. (0)

Anonymous Coward | more than 6 years ago | (#20918527)

-1, Uncomfortable Fact.

Re:Isaac Asimov died of AIDS. (1)

timmarhy (659436) | more than 6 years ago | (#20918625)

that was in 1983 you tard, before they understood how hiv was transmitted.

Possible implications on blood storage (5, Insightful)

WillAffleckUW (858324) | more than 6 years ago | (#20917865)

1. This is a study with participants highly linked to a firm that makes money off of adding NO to blood products. They have financial and other incentives to find a "lack" of NO in stored blood.

2. As with any study, an independent study should be done to see if this is verifiable and repeatable. This should be done by a lab that is not financially or otherwise linked to the NO additive firm aforementioned.

3. The other thing to look at is method of storage, temperature, and other conditions - did they conform to current standards, did they vary these elements, and was this independently audited?

more than just bias that I would be concerned abou (2, Informative)

irtza (893217) | more than 6 years ago | (#20918053)

Well, not having read the study I can not comment on its significance; however, there is far more to blood transfusion dangers than NO depletion.

Lets get to some significant points: NO is produced locally at the tissues that need it.

RBC fragility is likely more significant than the effects of one vasodilator

Multiple unnecessary (or necessary) transfusions may lead to iron overload similar to that found in people with hemachromatosis

TRALI

I am not attacking their work, but there are so many other reasons to be vary of transfusions - the significance of this one seems like it would be minimal, but I do applaud their work in trying to minimize complications of transfusion.

Re:Possible implications on blood storage (1)

sco08y (615665) | more than 6 years ago | (#20918741)

1. This is a study with participants highly linked to a firm that makes money off of adding NO to blood products. They have financial and other incentives to find a "lack" of NO in stored blood.

Or they found the lack of NO in stored blood and made the product to solve the problem. It's fine to look for corroborating evidence, but scientists at drug companies are just like scientists everywhere else and they really don't just make shit up for money. Kneejerk doubt isn't any more rational or wise than kneejerk faith.

Re:Possible implications on blood storage (0)

Anonymous Coward | more than 6 years ago | (#20920831)

they found the lack of NO in stored blood and made the product to solve the problem. It's fine to look for corroborating evidence, but scientists at drug companies are just like scientists everywhere else and they really don't just make shit up for money.

The real question is whether the degradation of NO in stored blood is an actual problem. NO is not particularly soluble in water (or blood). It's generated continuously by various tissues in order to regulate blood flow (among other things), but is not generated by the blood itself. The NO content of normal blood varies substantially depending on conditions.

It's not like the transfused blood somehow repels the NO generated by the body. One imagines that normal, homeostatic mechanisms quickly replace any NO absent in the transfused blood. Serious question: are the NO degradation byproducts (eg nitrosylated proteins) detrimental?

Their product may address a real phenomenon: less NO in "stale" blood. There's less oxygen in "stale" water: does that make it "bad?" Should I spend the extra money on oxygenated water?

Re:Possible implications on blood storage (1)

Eivind Eklund (5161) | more than 6 years ago | (#20922973)

I'd say kneejerk doubt is slightlybetter, as science runs on skepticism.

This is not a new concept (4, Informative)

Anonymous Coward | more than 6 years ago | (#20918003)

That's one poor summary.

It's well known that packed red blood cells or whole blood is not as effective as fresh blood at transporting hemoglobin. This is because of several factors, notably shifts in 2,3-BPG, ATP, ADP during storage as well as partially due to the calcium citrate used to prevent clotting of the stored blood.

While it isn't ideal, our current method is by far the safest way to give blood, simply because you cannot screen blood for deadly pathogens in the time it takes for blood to start to degrade. While many people have researched ways to shift the binding characteristics of stored blood back to fresh blood, and with some success on manipulation of hemoglobin's oxygen binding curves, overall the clinical effect for patients has been minimal.

The nitrous-oxide pathway, to my knowledge, has not been tried yet, but I'd hate to have my blood pre-mixed with a drug that would kill a percentage of the patients who are candidates for blood transfusion. When someone is exsanguinating, you want to INCREASE their blood pressure, not decrease it.

On the other hand, in ischemic disease you do want to give nitro, in certain situations, but preferably not pre-mixed with the blood, and we already do this, just not in strokes, yet.

How it worked in 1960's Mexico (0)

Anonymous Coward | more than 6 years ago | (#20918043)

One of my mom's uncles has the same blood type as her. As a girl my mom needed to have lots of surgery. When she needed blood, my uncle would donate blood specifically for my mom. No need to worry about oxygen levels!

Re:How it worked in 1960's Mexico (0, Offtopic)

NerveGas (168686) | more than 6 years ago | (#20918221)

And what if someone isn't around with the right blood type?

I have a fairly rare blood type, I used to get called regularly asking me to donate more. Well, until they gave me a false positive for HIV. Despite the fact that I flat-out don't have HIV (and all subsequent tests backed that up), I'm still not allowed to donate again, ever.

One of the rules about blood donation that seems odd is that if you have received a blood transfusion, you wait for a full year before you can give blood again. Since it doesn't take anywhere near that long for your body to "fill up" again, that seems like they're saying "Hey, we don't really have a lot of confidence in our own system."

Re:How it worked in 1960's Mexico (1)

BootNinja (743040) | more than 6 years ago | (#20918491)

Where I live, they allow you to donate about every 2 months. And they call and pester you every two months to please come and donate.

Re:How it worked in 1960's Mexico (1)

timmarhy (659436) | more than 6 years ago | (#20918533)

medicine isn't an exact science. There is always a margin for unknown error, which is why they make you wait a year just in case.

it's called being responsible and taking the right precautions.

confidence has nothing to do with it.

Re:How it worked in 1960's Mexico (1)

demonlapin (527802) | more than 6 years ago | (#20919819)

It takes roughly six months for those who have been exposed to HIV to seroconvert (if they do so at all). Doubled for safety. After what happened to the industry after Ryan White and all the other hemophiliac kids of the 80s, wouldn't you?

artificial blood has the same problem (1)

wizardforce (1005805) | more than 6 years ago | (#20918049)

There was a similar problem with fluorocarbon based blood substitutes in that they also increased the risk of stroke. perhaps this problem with nitrogen monoxide is the cause of the higher risk of stroke

How likely is this? (0, Redundant)

Ancient_Hacker (751168) | more than 6 years ago | (#20918057)

Blood transfusions have been going on for something like a century. A lot more successful once they figured out the compatible blood types.

Now this "news report" would have us believe that there's been a problem all this time, and either nobody did any research on it, or if they did they were total numbskulls to not see the connection between lowered oxygen efficacy and the lowering of chemical X.

Smells a teeensy bit fishy.

Re:How likely is this? (1)

nursegirl (914509) | more than 6 years ago | (#20918417)

It's actually remarkably difficult to notice trends that happen "in the first 30 days after a transfusion," because there's so many health issues to control for. So, whether this is true or not (I RTFA but not the journal article it's based on), I can understand why it would take a long time to realize that there was a correlation between blood older than 1 day and heart attacks/stroke.

Nitric oxide and not nitrous oxide (0, Redundant)

technosattva (761682) | more than 6 years ago | (#20918085)

The slashdot article mentions Nitrous Oxide (N20 aka Dinitrogen Monoxide), but the original article talks about Nitric Oxide (NO = Nitrogen Monoxide). The wikipedia page [wikipedia.org] says that the two should not be confused. The former is an anesthetic, the latter is a "toxic air pollutant". Alas, this means that huffing whippets before giving blood isn't going to make it stay fresh longer.

Also.... (1)

Chairboy (88841) | more than 6 years ago | (#20918129)

Also, it doesn't taste as good.

Yeah, it's definitely not very effective. (1)

NerveGas (168686) | more than 6 years ago | (#20918153)

When my wife lost 2/3 of the blood in her body, those extra pints they put in her didn't do anything at all. Well, other than keep her alive. Sheesh, to think that's *all* it did. Crappy, old blood.

Re:Yeah, it's definitely not very effective. (1)

Jesus_666 (702802) | more than 6 years ago | (#20920271)

Well, it might also have given her a healthier skin tone. At least healthier than without blood.

Blood: The cosmetic you just can't live without.

JW alert (0)

Anonymous Coward | more than 6 years ago | (#20918181)

I see they're coming out of the woodwork and posting on /. These type of stories are music to their ears. Former JWs know what I'm talking about.

This is exactly why we need a place (1)

greymond (539980) | more than 6 years ago | (#20918197)

where we can store extra humans, or perhaps clones to insure proper blood type and rely on their parts when we real people need to be repaired.

Re:This is exactly why we need a place (1)

rebelcan (918087) | more than 6 years ago | (#20918967)

And these clones, we can tell them they're going to an awesome tropical paradise whenever we need to harvest parts.

And we'll store them in a bunker. Out in the Nevada desert ( dessert? ).

Platelets (0)

Anonymous Coward | more than 6 years ago | (#20918391)

Platelet storage time: 5 days max.

They need your platlets. Give the ABC apheresis [stanford.edu] way. Thank you.

Re:Platelets (1)

PCM2 (4486) | more than 6 years ago | (#20919241)

I've donated using this method, but they asked that I give a double serving of red blood cells, rather than platelets. Your blood bank will tell you what would be most useful to receive from you, based on your own characteristics as well as current demand.

(BTW, the upshot of donating double red cells is that you won't have to give again for twice as long.)

Shelf-life (1)

chinton (151403) | more than 6 years ago | (#20919233)

Does banked blood last longer than a DVD-backup?

This is why ... (1)

hmm_slashdot (1170681) | more than 6 years ago | (#20919977)

This is exactly why I get all my blood fresh.

Artificial blood (1)

Lord Apathy (584315) | more than 6 years ago | (#20920215)

Whatever happened to artificial blood? I've been reading/hearing about this shit for years. Most of the reports are it's close to being ready or ready right now. Then it just vanishes. It's like someone pulls the plug on it. This would solve all the problems with blood shortage, blood going bad, and blood being tainted. It other words, everything.

Transfusions and Nitric Oxide (1)

crowbarsarefornerdyg (1021537) | more than 6 years ago | (#20920759)

The nitric oxide causes the blood vessels to relax and allow more blood to flow. It doesn't matter how much O2 the red blood cell carries, if it can't get where it's headed, it might as well be covered in cyanide.

As another poster said, if you're bleeding out, you want to replace blood as fast as possible. Opening the blood vessels would just make the bleeding worse. Yes, blood transfusions save lives. There is no argument about that. They're not saying that transfusions are bad; in fact, they're asking for clinical trials to find out whether or not the amount (or lack of) nitric oxide is clinically significant. Here are their words on the subject:

From TFA:
Stamler agreed on the need for clinical trials.

"Banked blood is truly a national treasure that needs to be protected," Stamler said. "Blood can be life saving, only it is not helping the way we had hoped and in many cases it may be making things worse. In principle, we now have a solution to the nitric oxide problem -- we can put it back -- but it needs to be proven in a clinical trial."

I will wait for the journal article ... (1)

kms_md (991224) | more than 6 years ago | (#20920795)

While Dr. Stamler's supposition is interesting, I would like to see the data and not an AP or Time magazine story. A search of "JS Stamler" on Pubmed shows 183 papers - 30 of which as first author and almost all dealing with NO. I would guess that he is probably an authority on NO. But that in and of itself does not mean that he is an authority on transfusion medicine, trauma care, surgery, or the like. I am interested to see which variables were controlled, what the power of the study was, and in what fashion data were obtained. The article and abstract are not yet up at the PNAS website.

Yuo Fa1l It! (-1, Flamebait)

Anonymous Coward | more than 6 years ago | (#20920963)

lagged b,ehinD,

I work for the American Red Cross (5, Informative)

DrStoooopid (1116519) | more than 6 years ago | (#20921593)

..naturally I'm biased.

I work in I.T. for ARC, but previous to that, I worked on the front lines, collecting the blood.

Allow me to give you a mini-tour.

First, the donor is required to read and acknowledge that they've read the health history guidelines.

Then the donor is required to get their vitals checked, answer several health related questions.

At that point the donor is placed on the donor bed. Their information is rechecked for accuracy.

Their arm is scrubbed using a two-step method.

The venipuncture is performed.

Now here's the important part. The blood comes into the bad which is filled with an anti-coagulant solution, and for it to be a "good unit"...we can only collect so much blood/per anti-coag...the entire unit is measured by weight @ 610g +/- 5% (for a proper whole blood to anti-coag solution). I may be slightly off on the ratio, it's been a while.

Then the unit is packed on ice, and maintained at a constant temperature.

Then the blood goes to the production lab, where the platelets and plasma are expressed and harvested for other uses.

The red blood cells are then introduced to a red cell preservative, (this is the part that makes the blood viable for 42 days)

The units are then either flash frozen, or they're placed in quarantine until the test results are back from the NTL (national testing lab).

but here's the chink in the armor of the original poster's argument. Our blood supply is so low right now in the US, that his argument is a moot point. 99% of the time, the blood isn't even on the shelf that long. Every 2 seconds, someone in the U.S. needs a transfusion of packed red cells....someone like me, who is 0-, CMV-.....I'm pretty much fucked....there won't be any blood available for me. (so all you O-'s...please go donate...lol)...

Anyway....yes, units do lose their potency over time...but part of the process is to ensure that the donor is healthy, and this helps ensure that when the blood is needed it will be as potent as possible.

At the American Red Cross, we make every effort to make sure that there's blood available when it's needed, where it's needed, and provide the best quality units, at the cheapest price, and make every effort to ensure that it's potent, and safe....that's from the very top of the food chain all the way down the janitors...we all love what we do, and we save lives.

That's not to say that occasionally there might be a 1/1,000,000 unit that didn't do the job, but I like those odds

Donating to Yourself (3, Interesting)

Doc Ruby (173196) | more than 6 years ago | (#20921865)

"Autologous" donations are donations extracted from you when you're healthy enough, like in advance of surgery, for use later, like when you need it during/after surgery. Currently, it's infrequent, and suffers from the same problems (possibly) identified by this study after a while.

But if you donated blood in advance of surgery, and it were used within a few hours, you could get a credit for blood later on when you need it urgently. If everyone scheduled for surgery were required to donate blood in advance (if they were healthy enough to do so), there would be so much blood available all the time that the fresh stuff would never be in short supply.

The infrastructure is in place right now. The techniques are nearly the same, just a tiny little DB and fridge shuffling to keep the fresh stuff flowing, and discard the extra as it ages.

All that's required to permanently end the incessant "blood shortages" and blood drives that could work on something else instead, would be making these donations a requirement.

Supplement NO (1)

madbawa (929673) | more than 6 years ago | (#20922631)

Ingredients:
1 packet of stored donated blood
2 scoops of NitroTech Hardcore Chocolate powder
16 oz. 2% fat milk

Method:
Mix all ingredients in a blender and transfuse intravenously. Patient will recover instantly and hit the gym.

CAUTION:
Do not use on patients with hernia problems. Hitting gym post transfusion may aggravate condition.

Maybe Viagra (1)

maroberts (15852) | more than 6 years ago | (#20923973)

Since Viagra (and smilar drugs) are meant to be some sort of Nitric Oxide booster, maybe adding a small dose of this will keep the patients alive (horny as hell, but alive)!

Australian Red Cross won't say what bags ut uses. (0)

Anonymous Coward | more than 6 years ago | (#20924379)

Our reports on this problem included RC guy
sayung they don't yet -know- what kind of
bags they use... dim bulbs in the marquis of Life?
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