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A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products.

Publication ,  Journal Article
Bennett-Guerrero, E; Lockhart, EL; Bandarenko, N; Campbell, ML; Natoli, MJ; Jamnik, VK; Carter, TR; Moon, RE
Published in: Transfusion
March 2017

BACKGROUND: Randomized trials, for example, RECESS, comparing "young" (median, 7-day) versus "middle-aged" (median, 28-day) red blood cells (RBCs), showed no difference in outcome. These data are important; however, they do not inform us about the safety and effectiveness of the oldest RBCs, which some patients receive. It may not be feasible to conduct a clinical trial randomizing patients to receive the oldest blood. Therefore, we propose strenuous exercise (VO2 max testing) as a model to study the relative efficacy to increase oxygen delivery to tissue of different RBC products, for example, extremes of storage duration. STUDY DESIGN AND METHODS: In this pilot study, eight healthy subjects had 2 units of leukoreduced RBCs collected by apheresis in AS-3 using standard methods. Subjects were randomized to receive both (2) units of their autologous RBCs at either 7 or 42 days after blood collection. VO2 max testing on a cycle ergometer was performed 2 days before (Monday) and 2 days after (Friday) the transfusion visit (Wednesday). This design avoids confounding effects on intravascular volume from the 2-unit blood transfusion. The primary outcome was the difference in VO2 max between Friday and Monday (delta VO2 max). RESULTS: VO2 max increased more in the 7-day RBC arm (8.7 ± 6.9% vs. 1.9 ± 6.5%, p = 0.202 for comparison between arms). Exercise duration (seconds) increased in the 7-day RBC arm (8.4 ± 1.7%) but actually decreased in the 42-day arm (-2.6 ± 3.6%, p = 0.002). CONCLUSIONS: This pilot study suggests that VO2 max testing has potential as a rigorous and quantitative in vivo functional assay of RBC function. Our preliminary results suggest that 42-day RBCs are inferior to 7-day RBCs at delivering oxygen to tissues.

Duke Scholars

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

March 2017

Volume

57

Issue

3

Start / End Page

630 / 636

Location

United States

Related Subject Headings

  • Time Factors
  • Pilot Projects
  • Oxygen
  • Models, Biological
  • Male
  • Humans
  • Female
  • Erythrocytes
  • Erythrocyte Transfusion
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
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Bennett-Guerrero, E., Lockhart, E. L., Bandarenko, N., Campbell, M. L., Natoli, M. J., Jamnik, V. K., … Moon, R. E. (2017). A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products. Transfusion, 57(3), 630–636. https://doi.org/10.1111/trf.13918
Bennett-Guerrero, Elliott, Evelyn L. Lockhart, Nicholas Bandarenko, Mary L. Campbell, Michael J. Natoli, Veronika K. Jamnik, Timothy R. Carter, and Richard E. Moon. “A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products.Transfusion 57, no. 3 (March 2017): 630–36. https://doi.org/10.1111/trf.13918.
Bennett-Guerrero E, Lockhart EL, Bandarenko N, Campbell ML, Natoli MJ, Jamnik VK, et al. A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products. Transfusion. 2017 Mar;57(3):630–6.
Bennett-Guerrero, Elliott, et al. “A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products.Transfusion, vol. 57, no. 3, Mar. 2017, pp. 630–36. Pubmed, doi:10.1111/trf.13918.
Bennett-Guerrero E, Lockhart EL, Bandarenko N, Campbell ML, Natoli MJ, Jamnik VK, Carter TR, Moon RE. A randomized controlled pilot study of VO2 max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products. Transfusion. 2017 Mar;57(3):630–636.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

March 2017

Volume

57

Issue

3

Start / End Page

630 / 636

Location

United States

Related Subject Headings

  • Time Factors
  • Pilot Projects
  • Oxygen
  • Models, Biological
  • Male
  • Humans
  • Female
  • Erythrocytes
  • Erythrocyte Transfusion
  • Cardiovascular System & Hematology