Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Influence of transfusions of allogeneic blood components on the level of systemic inflammatory response in neonates and infants of the first year of life

Authors: K.K. Osilov, R.G. Grigor'yants, N.N. Samsonova

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Medical Sciences; Rublevskoe shosse, 135, Moscow, 121552, Russia

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2013; (): -

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Abstract

Objective of the study is to analyze the relationship between the number of donors who provided blood for transfusions for surgical procedures for congenital heart disease in neonates and infants of the first year of life and the level of systemic inflammatory response in this category of patients.

Material and methods. The work was based on the study of the treatment of 234 cardiosurgical patients. The study group included 164 patients, who received only virus-inactivated fresh frozen blood combined with erythrocyte suspension from a single donor for the filling of circuit during extracorporeal circulation. The control group consisted of 70 patients who received quarantined plasma and erythrocyte suspension from several donors during extracorporeal circulation. Immunological status of the patients was assessed by the level of anti-inflammatory cytokines. A comparative analysis of the parameters TNF-α (tumor necrosis factor α), IL-8 (interleukin- 8) and IL-10 (interleukin-10) was conducted on all stages (before surgery, on the 1-st, 3-d, 7-th post-operative days) of the clinical observation in the study group and control group.

Results. On the stage I TNF-α level was 8.3±1.6 pg/ml in the study group and 8,6±1,5 pg/ml in the control group. On the stage II statistically significant difference was observed between two groups of patients: TNF-α level increased to 26.2±2.9 pg/ml in the study group, and – up to 47.7±8.3 pg/ml in the control group. On the 7-th post-operative day the same indicator was 24.1±4.2 pg/ml in the study group, and it remained on the high level in the control group – 41.1±5.7 pg/ml. The mean IL-8 level on the stage IV was 70.9±8.1 pg/ml in the study group and 104.7±12.7 pg/ml in the control group. If on the first three stages of the study the IL-10 level fluctuated within the reference range (< 9.1 pg/ml), then on stage IV its level significantly increased in the control group and it exceeded 1.5 times the admissible norm (14.3±4.1 pg/ml).

Conclusion. Analysis of our own clinical studies showed that in allogeneic blood transfusions immunological status of a patient is related to the number of donated units of blood and the transfusion of virus-inactivated fresh frozen plasma combined with erythrocyte suspension from a single donor is undoubtedly more preferable than the use of blood components from several donors during the surgical repair of complex congenital heart disease with extracorporeal circulation in neonates and infants of the first year of life.

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