Physiology of marathons amounts of blood to and from the lungs to reach all bodily tissues is dependent on having a high cardiac output along with sufficient levels of total body hemoglobin. Hemoglobin is the oxygen carrying protein within blood cells that allows for the proper transportation of oxygen from the lungs to other bodily tissues via the circulatory system. In order for the transportation of oxygen in blood to be effective during a marathon, the distribution of blood needs to be equally efficient in order for a marathoner's oxygen demands to be met during a race. The mechanism that allows for this
Packed red blood cells are kept with a minimal amount of fluid. Generally, an additive solution of citrate, dextrose, and adenine is mixed with the cells to keep them alive during storage. This process is sometimes done as automated apheresis, where the centrifuging and mixing take place at the donation site. Red blood cells are sometimes modified to address specific patient needs. The most common modification is leukoreduction, where the donor blood is filtered to remove white cells, although this is becoming increasingly universal throughout the blood supply (over 80% in the US, 100% in Europe). The blood may also be irradiated, which destroys