1. The Blood Is The Life
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In modern medical treatments, patients may receive a pint of whole blood or just the specific components of the blood that are needed to treat their particular condition. This approach to treatment, referred to as blood component therapy, allows several patients to benefit from one pint of donated whole blood.
The transfusable components that can be derived from donated blood are red cells, platelets, plasma, cryoprecipitated AHF (cryo), and granulocytes. An additional component, white cells, is often removed from donated blood before transfusion.
A whole blood donation requires minimal processing before it is ready to be transfused into a patient. If not needed right away, whole blood can be refrigerated for up to 35 days, depending on the type of anticoagulant used.
Red blood cells (RBCs), or erythrocytes, give blood its distinctive color. Produced in our bone marrow, they carry oxygen from our lungs to the rest of our bodies and take carbon dioxide back to our lungs to be exhaled. There are about one billion red blood cells in two to three drops of blood.
Red blood cells are prepared from whole blood by removing the plasma (the liquid portion of the blood). They have a shelf life of up to 42 days, depending on the type of anticoagulant used. They can also be treated and frozen for 10 years or more.
Leukocyte-reduced RBCs are prepared by removing leukocytes (white blood cells) by filtration shortly after donation. This is done before the RBCs are stored because over time the leukocytes can fragment, deteriorate, and release cytokines, which can trigger negative reactions in the patient who receives them. These reactions can occur during the initial transfusion or during any future transfusions.
Platelets, or thrombocytes, are small, colorless cell fragments in our blood whose main function is to stick to the lining of blood vessels and help stop or prevent bleeding. Platelets are made in our bone marrow.
Blood plasma serves several important functions in our bodies, despite being about 92% water. (Plasma also contains 7% vital proteins such as albumin, gamma globulin and anti-hemophilic factor, and 1% mineral salts, sugars, fats, hormones and vitamins.) It helps us maintain a satisfactory blood pressure and volume, and supplies critical proteins for blood clotting and immunity. It also carries electrolytes such as sodium and potassium to our muscles and helps to maintain a proper pH (acid-base) balance in the body, which is critical to cell function.
Plasma is obtained by separating the liquid portion of blood from the cells. Plasma is frozen within 24 hours of being donated in order to preserve the valuable clotting factors. It is then stored for up to one year, and thawed when needed.
Cryoprecipitated Antihemophilic Factor (Cryo) is a portion of plasma rich in clotting factors, including Factor VIII and fibrinogen. These clotting factors reduce blood loss by helping to slow or stop bleeding due to illness or injury.
Cryo is used to prevent or control bleeding in people whose own blood does not clot properly. This includes patients with hereditary conditions such as hemophilia and von Willebrands disease. Cryo is also a source of fibrinogen for patients who cannot produce the necessary amount of this important clotting protein on their own.
Background: The associations of blood pressure with the different manifestations of incident cardiovascular disease in a contemporary population have not been compared. In this study, we aimed to analyse the associations of blood pressure with 12 different presentations of cardiovascular disease.
Methods: We used linked electronic health records from 1997 to 2010 in the CALIBER (CArdiovascular research using LInked Bespoke studies and Electronic health Records) programme to assemble a cohort of 1·25 million patients, 30 years of age or older and initially free from cardiovascular disease, a fifth of whom received blood pressure-lowering treatments. We studied the heterogeneity in the age-specific associations of clinically measured blood pressure with 12 acute and chronic cardiovascular diseases, and estimated the lifetime risks (up to 95 years of age) and cardiovascular disease-free life-years lost adjusted for other risk factors at index ages 30, 60, and 80 years. This study is registered at ClinicalTrials.gov, number NCT01164371.
Interpretation: The widely held assumptions that blood pressure has strong associations with the occurrence of all cardiovascular diseases across a wide age range, and that diastolic and systolic associations are concordant, are not supported by the findings of this high-resolution study. Despite modern treatments, the lifetime burden of hypertension is substantial. These findings emphasise the need for new blood pressure-lowering strategies, and will help to inform the design of randomised trials to assess them.
It takes about 60 seconds for all the blood in your body to complete its journey. It travels from your heart to your extremities and returns, there and back again. Blood moves with the rapid current of the great arterial rivers and through the smallest capillary creeks. William Harvey first noticed circulation (1628) through the heart into arteries and veins; however, he could not see how they connected since he did not have a microscope. The man who first described this was Anton van Leeuwenhoek about 46 years later (1674). Then, J. J. Lister and Thomas Hodgkin described the rouleaux formation or stacking of RBCs through a capillary bed. All of these men mentioned above were committed Christians.
Blood is a rich scarlet soup of proteins and cells that keeps us alive. A few nights working in an emergency room would probably convince you that the body is just a huge bag of blood. Actually, in an average 70-liter human body, only five liters, or 7% by volume, is blood. Normally, blood is found in the heart, in blood vessels, and in the sinusoids of the marrow, liver, and spleen. Of the average five liters of blood, only 2.25 L, or 45%, consists of cells. Erythrocytes, leukocytes, and platelets are the formed elements of blood. The rest is plasma that consists of 91.5% water (by weight) and 8.5% solids (mostly albumin). Of the 2.25 L of cells, only 0.037 L (1.6%) are leukocytes (Fig. 2). The entire circulating leukocyte population, if purified, would fit in a coffee cup. The total circulating platelet volume is even less, about 0.0065 L, or about one teaspoonful. Because blood is the connecting fluid to all the body systems and is the substance upon which all body cells are dependent, we explore blood as it relates to all the physiological patterns.
The fabric-of-life idea reveals that the Creator purposely wove together both blood and lymphatic capillaries. The Master Weaver also stitched a network of vessels containing dozens of specialized cells to form a finished masterpiece fabric that surpasses all others in intricacy, specificity, and beauty. Upon closer examination, one can see that no matter what level of the body is analyzed (e.g., organ, tissue, cellular, or molecular), elegant design is seen.
Blood is a river of life that surges within us, and a blood test reveals how healthy we are. Blood has enormous importance in the practice of medicine. Clinicians examine it more often than any other tissue trying to determine the cause of a disease in their patients. In my microbiology and parasitology classes, we talk about its revealing power in interpreting a complete blood count and how abnormal counts reveal an infectious or parasitic disease (Table 1). 781b155fdc