Evidence map›Paper›PMID 23480490›Full record

ArticleTransfusion2013

Red blood cells stored for increasing periods produce progressive impairments in nitric oxide-mediated vasodilation.

Jason T Alexander, Alexander M El-Ali, James L Newman, Sulaiman Karatela, Benjamin L Predmore, David J Lefer, Roy L Sutliff, John D Roback

Abstract read
In one paragraph

Article in Transfusion, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 48 citations in OpenAlex.

  1. Trial
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  6. Review
  7. Review
  8. Red blood cell storage lesion: causes and potential clinical consequences.Blood transfusion = Trasfusione del sangue · 2019
    Review
  9. Article
  10. RBC Transfusions Are Associated With Prolonged Mechanical Ventilation in Pediatric Acute Respiratory Distress Syndrome.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2018
    Article
  11. Influence of red blood cell-derived microparticles upon vasoregulation.Blood transfusion = Trasfusione del sangue · 2017
    Review
  12. Article
  13. Review
  14. Article
  15. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Jason T AlexanderDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
Alexander M El-AliDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
James L NewmanDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
Sulaiman KaratelaDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
Benjamin L PredmoreDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
David J LeferDivision of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
Roy L Sutliff *Division of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
John D Roback *Division of Pulmonary Medicine, Department of Medicine, the Center for Transfusion and Cellular Therapies, Department of Pathology and Laboratory Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, Atlanta, Georgia.
Emory University · USAtlanta University Center · USAtlanta VA Medical Center · US

Funding

Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Adverse effects of RBC transfusions: A unifying hypothesisR01HL095479 · NHLBI · EMORY UNIVERSITY · PI ROBACK, JOHN D · 2009 to 2017
$5.2M
NCATS NIH HHS UL1 TR000454NHLBI NIH HHS R01 HL095479
6 · The paper itself

Abstract

backgroundClinical outcomes in transfused patients may be affected by the duration of blood storage, possibly due to red blood cell (RBC)-mediated disruption of nitric oxide (NO) signaling, a key regulator of vascular tone and blood flow. STUDY DESIGN AND

methodsAS-1 RBC units stored up to 42 days were sampled at selected storage times. Samples were added to aortic rings ex vivo, a system where NO-mediated vasodilation could be experimentally controlled.

resultsRBC units showed storage-dependent changes in plasma hemoglobin (Hb), RBC 2,3-diphosphoglycerate acid, and RBC adenosine triphosphate conforming to expected profiles. When freshly collected (Day 0) blood was added to rat aortic rings, methacholine (MCh) stimulated substantial NO-mediated vasodilation. In contrast, MCh produced no vasodilation in the presence of blood stored for 42 days. Surprisingly, the vasoinhibitory effects of stored RBCs were almost totally mediated by RBCs themselves: removal of the supernatant did not attenuate the inhibitory effects, while addition of supernatant alone to the aortic rings only minimally inhibited MCh-stimulated relaxation. Stored RBCs did not inhibit vasodilation by a direct NO donor, demonstrating that the RBC-mediated vasoinhibitory mechanism did not work by NO scavenging.

conclusionsThese studies have revealed a previously unrecognized vasoinhibitory activity of stored RBCs, which is more potent than the described effects of free Hb and works through a different mechanism that does not involve NO scavenging but may function by reducing endothelial NO production. Through this novel mechanism, transfusion of small volumes of stored blood may be able to disrupt physiologic vasodilatory responses and thereby possibly cause adverse clinical outcomes.

Indexed as

Blood PreservationVasodilationAdenosine TriphosphateAnimalsErythrocytesHemoglobinsHumansMethacholine ChlorideNitric OxideRatsTime FactorsAdenosine TriphosphateHemoglobinsMethacholine ChlorideNitric Oxide

Identifiers

PMID23480490
PMCPMC4140194
OpenAlexW1937260137

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.