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Automated Red Cell Exchange in Sickle Cell Disease

تبديل الكريات الحمر الآلي في فقر الدم المنجلي

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 Publication date 2012
and research's language is العربية
 Created by Shamra Editor




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The majority of patients with SCD receive transfusions at some point in their life. Transfusion can be simple transfusion or exchange transfusions which offer better control of blood volume and viscosity. Such transfusions are most readily accomplished via automated red cell exchange. Evaluate the results of our experience in applying the technique of selective cell separation by continuous flow (Cytapheresis) for automated red cell exchange for patients with sickle cell anemia to reduce the level of hemoglobin S (HbS) in certain cases, especially in preparation for major surgery.


Artificial intelligence review:
Research summary
تتناول هذه الدراسة تطبيق تقنية الفصل الخلوي الانتقائي بالتنبيذ بالجريان المستمر (Cytapheresis) لإجراء تبديل كريات حمر آلي لمرضى فقر الدم المنجلي. تم إجراء الدراسة بين عامي 2005 و2007 باستخدام جهاز فصل الخلايا من شركة Fresenius AG، وشملت 15 مريضًا بمتوسط عمر 31.2 سنة. كانت الاستطبابات الرئيسية تشمل الجراحة العظمية (53.3%) واستئصال الحويصل الصفراوي (26.6%) ونوب الألم المعندة (6.6%) وغيرها. أظهرت النتائج أن متوسط نسبة تخفيض الخضاب المنجلي كانت 52%، ومتوسط حجم الكريات الحمر المستخدمة كان 1412.4 مل، ومتوسط زمن الجلسة كان 76.5 دقيقة. خلصت الدراسة إلى أن تبديل الكريات الحمر الآلي هو إجراء آمن وفعال في خفض مستوى الخضاب المنجلي إلى مستويات آمنة للجراحات الكبرى وعلاج نوب الانسداد الوعائي.
Critical review
دراسة نقدية: على الرغم من أن الدراسة تقدم نتائج مشجعة حول فعالية وأمان تقنية تبديل الكريات الحمر الآلي، إلا أن هناك بعض النقاط التي يمكن مناقشتها. أولاً، حجم العينة صغير نسبياً (15 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم مقارنة النتائج مع مجموعة ضابطة تتلقى العلاج التقليدي، مما يجعل من الصعب تقييم الفعالية النسبية للتقنية الجديدة. ثالثاً، لم يتم التطرق بشكل كافٍ إلى التكلفة والموارد المطلوبة لتنفيذ هذه التقنية، والتي قد تكون عائقاً في بعض البيئات الطبية. وأخيراً، كان من المفيد تقديم متابعة طويلة الأمد للمرضى لتقييم الآثار الجانبية المحتملة والمضاعفات التي قد تظهر بعد فترة من العلاج.
Questions related to the research
  1. ما هي التقنية المستخدمة في الدراسة لتبديل الكريات الحمر؟

    تم استخدام تقنية الفصل الخلوي الانتقائي بالتنبيذ بالجريان المستمر (Cytapheresis) لتبديل الكريات الحمر الآلي.

  2. ما هي الاستطبابات الرئيسية لتبديل الكريات الحمر الآلي في الدراسة؟

    الاستطبابات الرئيسية تشمل الجراحة العظمية (53.3%)، استئصال الحويصل الصفراوي (26.6%)، نوب الألم المعندة (6.6%)، النعوظ المؤلم المعند (6.6%)، وقرحة الساق المعندة (6.6%).

  3. ما هو متوسط نسبة تخفيض الخضاب المنجلي بعد جلسة التبديل؟

    متوسط نسبة تخفيض الخضاب المنجلي كانت 52%.

  4. ما هي مدة الجلسة الواحدة لتبديل الكريات الحمر الآلي؟

    متوسط زمن الجلسة الواحدة كان 76.5 دقيقة.


References used
Montalembert. M, Galacteros.F, Girot.R, Geffrier.A.Ch. Prise en charge de la drépanocytose chez l`enfant et l`adolescent. Recommandations pour la pratique clinique .HAS / Service des recommandations professionnelles.France 2005 :1-31. http://www.has-sante.fr/portail/jcms/c-269713/drepanocytose-argumentairepdf
Aliyu.Z.Y, Tumblin.A.R, Kato.J.G. Current therapy of sickle cell disease. haematologica/ the hematology journal 2006; 91(1):7-10
Kim.H.C. .RBC Exchange Transfusion to Prevent Iron Overload in Patients with Sickle Cell Disease.5ht Brazilian symposium for sickle cell disease and other hemoglobinopathies, USA 2009. http://www.cehmob.org.br/simposio/imagens/download/palestras/KIM_Haewon.pdf
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