With the advancement of technology in monitoring the measure of oxygen deficit to tissues (critical delivery of oxygen) in real time, it allowed science to move forward and put down the concept that the administration of exogenous blood improves the physiology or homeostasis of the individual. The erroneous concept that the critical offer of Oxygen (DO2) and hemoglobin level are directly linked, increasing / decreasing hemoglobin increases / decreases the offer of Oxygen is part of the daily life of the vast majority of doctors. The circulating hemoglobin level does not necessarily increase the offer of O2 to the tissues. The transfusion of halogenic blood not only does not improve but potentially worsens tissue oxygenation (400% reduction in O2 supply to tissues). Even in the face of numerous high–quality medical research data dealing with the damage that transfusion promotes to them, doctors insist on looking for a “trigger“ for a value that needs to be transfused. O2 delivery is highly regulated and stable over a very wide range of hemoglobin added to this; the more we provide halogenic hemoglobin there will be no corresponding increase in O2 supply to the tissues. The capillary hematocrit level is governed by the physical dynamics of fluids and endothelial cells have oxygen concentration sensitive receptors. The capillary hematocrit is always stable between 12% –15% and cannot be increased. Adding more hemoglobin will not increase the hematocrit unless the O2 supply is at a critical level. Hemoglobin is an excess O2 buffer at the tissue level because this same Oxygen is biotoxic and its excess in the tissues leads to DNA damage, mutations and eventually cell death (apoptosis). Thus understanding how microcirculation and hemoglobin work together to create a very stable balance. In 62 controlled and randomized clinical studies, no advantage was shown to transfused patients, so why does medicine continue to transfuse, transfuse ……
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