Nine treatments of 1000 mL therapeutic phlebotomy in a subject with polycythemia: A case report
Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64‐year‐old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy...
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| Published in | Physiological reports Vol. 12; no. 11; pp. e16035 - n/a |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
John Wiley & Sons, Inc
01.06.2024
John Wiley and Sons Inc Wiley |
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| Online Access | Get full text |
| ISSN | 2051-817X 2051-817X |
| DOI | 10.14814/phy2.16035 |
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| Abstract | Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64‐year‐old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre‐ and post‐phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies. |
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| AbstractList | Large-volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64-year-old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre- and post-phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies. Large-volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64-year-old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre- and post-phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies.Large-volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64-year-old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre- and post-phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies. Abstract Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64‐year‐old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre‐ and post‐phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient's tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies. |
| Author | Morton, William J. Hauge, Anton Søvik, Signe Opdahl, Helge Rein, Erling Bekkestad Hisdal, Jonny |
| AuthorAffiliation | 3 Department of Vascular Surgery Oslo University Hospital Oslo Norway 1 Department of Anaesthesia Akershus University Hospital Lørenskog Norway 4 Department of Acute Medicine, The Norwegian National CBRNE Medical and Advisory Centre Oslo University Hospital Oslo Norway 2 Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway |
| AuthorAffiliation_xml | – name: 4 Department of Acute Medicine, The Norwegian National CBRNE Medical and Advisory Centre Oslo University Hospital Oslo Norway – name: 2 Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway – name: 3 Department of Vascular Surgery Oslo University Hospital Oslo Norway – name: 1 Department of Anaesthesia Akershus University Hospital Lørenskog Norway |
| Author_xml | – sequence: 1 givenname: William J. orcidid: 0000-0002-3225-6321 surname: Morton fullname: Morton, William J. email: w.j.morton@studmed.uio.no organization: Oslo University Hospital – sequence: 2 givenname: Anton surname: Hauge fullname: Hauge, Anton organization: University of Oslo – sequence: 3 givenname: Helge orcidid: 0009-0003-4493-8105 surname: Opdahl fullname: Opdahl, Helge organization: Oslo University Hospital – sequence: 4 givenname: Erling Bekkestad surname: Rein fullname: Rein, Erling Bekkestad organization: University of Oslo – sequence: 5 givenname: Signe orcidid: 0000-0003-4524-2268 surname: Søvik fullname: Søvik, Signe organization: University of Oslo – sequence: 6 givenname: Jonny orcidid: 0000-0002-0224-7854 surname: Hisdal fullname: Hisdal, Jonny organization: Oslo University Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38844733$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1093/bja/aeu232 10.1111/anae.15866 10.1001/archinte.1992.00400140110024 10.1016/j.jclinepi.2017.04.026 10.1152/japplphysiol.00070.2014 10.1152/physrev.00006.2018 10.1016/S0008-6363(98)00067-4 10.1111/j.1365-2257.1980.tb00810.x 10.1111/vox.12896 10.1177/1753944714553226 10.1007/BF02442607 |
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| Copyright | 2024 The Authors. published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society. 2024 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society. 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. info:eu-repo/semantics/openAccess |
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| Keywords | polycythemia phlebotomy human hemorrhage |
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| Snippet | Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute... Large-volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute... Abstract Large‐volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes... |
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| StartPage | e16035 |
| SubjectTerms | Blood pressure Case Report Ethics Heart Rate Hemochromatosis Hemochromatosis - therapy Hemodynamics Hemorrhage Hemorrhage - etiology Hemorrhage - therapy human Humans Male Middle Aged Patients Phlebotomy Phlebotomy - methods Polycythemia Polycythemia - therapy Ultrasonic imaging |
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| Title | Nine treatments of 1000 mL therapeutic phlebotomy in a subject with polycythemia: A case report |
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