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 the red blood cells using special equipment, such as the IBM 2991 cell processor in a similar manner to washing RBCs. The processing (often termed "manufacture", since the end result is deemed a biologic biopharmaceutical product) and the storage can occur at a collection center and/or a blood bank. RBCs are mixed with an anticoagulant and storage solution which provides nutrients and aims to preserve viability and functionality of the cells (limiting their so-called "storage lesion"), which are stored at refrigerated temperatures for up to 42 days (in the US), except for the rather unusual long-term storage in which case