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Bradykinin-associated reactions in white cell-reduction filter
1Department of Anesthesiology, Central Aizu General Hospital, Aizuwakamatsu, Japan.
Journal of Critical Care
|August 2, 2001
Summary
The negative filter generates bradykinin (a potential anaphylatoxin) from warm blood during transfusions, while positive filters do not. Temperature significantly impacts bradykinin generation, posing risks with warm blood transfusions.
Area of Science:
- Biomedical science
- Hematology
- Physiology
Background:
- Blood transfusions are critical medical procedures.
- Bradykinin is a vasoactive peptide.
- Filter materials can influence blood components.
Purpose of the Study:
- To investigate the impact of filter charge and temperature on bradykinin generation during blood transfusion.
- To compare bradykinin production using positively charged, negatively charged, and neutral filters.
Main Methods:
- Whole blood from volunteers was passed through different filters at 4°C and 37°C.
- Autologous blood transfusions were performed in surgical patients using positive and negative filters.
- Plasma bradykinin levels, blood pressure, and heart rate were monitored.
Main Results:
- The negative filter generated significant bradykinin from warm blood (4,000-fold increase), but not from cool blood.
- Positive filters did not generate bradykinin at any temperature.
- Warm blood transfusion with the negative filter caused decreased blood pressure and increased heart rate, with elevated plasma bradykinin.
- Neutral filters generated lower levels of bradykinin with warm blood compared to the negative filter.
Conclusions:
- The negative filter exhibits temperature-dependent bradykinin generation.
- Warm blood transfusions using negative filters can lead to bradykinin release, acting as a potential anaphylatoxin.
- Filter selection is crucial to mitigate bradykinin-related transfusion reactions.