Pinch-off syndrome in patients with sickle cell disease receiving erythrocytapheresis.

A 6-year-old female with homozygous sickle cell disease had a central venous access device (CVAD) placed to facilitate chronic erythrocytapheresis. Erythrocytapheresis was ineffective due to the rare pinch-off syndrome causing communication between the dual lumen tubing. Awareness of and monitoring for the pinch-off syndrome is indicated in people with sickle cell disease and a CVAD for chronic erythrocytapheresis.

Midpoint CD34 measurement as a predictor of PBPC product yield in pediatric patients undergoing high-dose chemotherapy.

High-dose chemo/radiotherapy of sensitive tumors requires PBPC rescue doses of >3 x 10(6) CD34/kg (range: 3-20 x 10(6) CD34/kg). Because of the diversity of stem cell treatment protocols and clinical presentation of patients at the time of peripheral blood progenitor cell (PBPC) harvest, the use of the mid-point CD34 positive cell measurement was initiated to predict the final CD34-positive cell product yield/stem cell harvest. The measurement of CD34-positive cells at the mid-point of the initial setting of 5 total blood volumes (TBV) allows for the extension, shortening, or no change in the TBV processing to achieve a maximum goal of CD34-positive cells/kg body weight required for stem cell transplantation.

Clinical performance of an in-line, ex vivo point-of-care monitor: a multicenter study.

Background: The management of critically ill infants and neonates includes frequent determination of arterial blood gas, electrolyte, and hematocrit values. An objective of attached point-of-care patient monitoring is to provide clinically relevant data without the adverse consequences associated with serial phlebotomy.

Methods: We prospectively determined the mean difference (and SD of the difference) from laboratory methods of an in-line, ex vivo monitor, the VIA LVM Blood Gas and Chemistry Monitoring System (VIA LVM Monitor; Metracor Technologies, Inc.