The Ability of Red Blood Cell Transfusions to Reach the Microcirculation

  • K. Yuruk
  • R. Bezemer
  • C. Ince
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM, volume 2012)


The ultimate goal of red blood cell (RBC) transfusions in anemic patients is to provide oxygen-rich blood to the microcirculation to improve tissue oxygenation [1]. There is little evidence, however, that this is actually achieved in patients. RBCs undergo several biochemical and hemorheological changes during their storage. Several clinical studies have reported blood transfusion-related complications associated with the aging of blood, such as increased mortality, multiple organ failure, infections, and prolonged hospital length of stay. Other studies, in contrast, have not found differences in outcome following transfusion of fresh blood or aged blood. At present, the studies on transfusion medicine have been mainly focused on the role of the quality of the transfused blood. These changes are commonly referred to as storage lesions and are held responsible for many of the deleterious effects of RBC transfusions. The presence of leukocytes and their by-products in stored blood may be another factor affecting in vivo function of transfused blood. Taken together, these biochemical and hemorheological changes during RBC storage may adversely affect the ability of transfused RBCs to deliver oxygen-rich blood to the microcirculation [2, 3]. As the ultimate aim of RBC transfusions is to promote microcirculatory oxygen delivery (DO2), the underlying disease should also be taken into consideration as this may interfere with the transfusion. In fact, in some disease states it has been shown that RBC transfusions may even have deleterious effects on the microcirculation [4, 5]. It seems that even though systemic hematocrit and hemoglobin levels rise following transfusion, the ability of transfused blood to actually reach the microcirculation and oxygenate the tissues may not be achieved [6].


Cardiac Surgery Patient Intensive Care Unit Length Functional Capillary Density Human RBCs Storage Lesion 
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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • K. Yuruk
  • R. Bezemer
  • C. Ince

There are no affiliations available

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