Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Adverse Effects of RBC Transfusions: A Unifying Hypothesis
Brief Summary: Transfusion of red blood cells is often used in critically ill patients with low red blood cell counts to prevent disease progression and death. Recent studies suggest that the use of "aged" versus "fresh" red blood cells are associated with worse clinical outcomes. There is evidence that red blood cells work with the cells lining our blood vessels to produce a variety of substances that normally cause arteries to relax and increase blood supply. Two of these substances are called nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF). The investigators are trying to determine the nature of these substances in human beings when they are transfused "aged" versus "fresh" red blood cells. It is their thought that "aged" red blood cells have less of the substances (NO and EDHF) that naturally relax our arteries and further changes the blood supply. One way to determine this is to transfuse a subject's own "aged" and "fresh" red blood cells and inject substances such as L-NMMA (L-NG monomethyl arginine) and TEA (tetraethylammonium chloride), which block the production of NO and EDHF respectively, and then, study what happens to the blood flow.

There is evidence that red blood cells produce NO, which normally causes arteries to relax and increase blood supply. The investigators will try to determine the nature of NO in red blood cells and whether the amount of this substance is altered because of different blood processing and storage techniques. It is their thought that "aged" red blood cells have less NO that naturally relaxes our arteries and further changes the blood supply. This study is designed to determine the most ideal way of storing and processing blood.


Options:
A: Arm Label: Standard of care; Type: ACTIVE_COMPARATOR; Interventions: Other: Blood transfusion | Arm Label: Arm B; Type: OTHER; Interventions: Other: Blood transfusion | Intervention Type: OTHER; Name: Blood transfusion; Assigned to Arm(s): Arm B, Standard of care
B: Arm Label: Fresh not-leukocyte-reduced RBCs; Type: ACTIVE_COMPARATOR; Interventions: Biological: Blood transfusion | Arm Label: Fresh RBCs leukocyte-reduced; Type: ACTIVE_COMPARATOR; Interventions: Biological: Blood transfusion | Arm Label: RBCs with storage longer than 15 days; Type: ACTIVE_COMPARATOR; Interventions: Biological: Blood transfusion | Intervention Type: BIOLOGICAL; Name: Blood transfusion; Assigned to Arm(s): Fresh RBCs leukocyte-reduced, Fresh not-leukocyte-reduced RBCs, RBCs with storage longer than 15 days
C: Arm Label: Fresh blood, then aged blood; Type: EXPERIMENTAL; Interventions: Biological: Fresh blood, Biological: Aged blood | Intervention Type: BIOLOGICAL; Name: Fresh blood; Assigned to Arm(s): Fresh blood, then aged blood | Intervention Type: BIOLOGICAL; Name: Aged blood; Assigned to Arm(s): Fresh blood, then aged blood
D: Arm Label: Short storage; Type: EXPERIMENTAL; Interventions: Biological: Blood transfusion | Arm Label: Long storage arm; Type: ACTIVE_COMPARATOR; Interventions: Biological: Blood transfusion | Intervention Type: BIOLOGICAL; Name: Blood transfusion; Assigned to Arm(s): Long storage arm, Short storage

Answer: C