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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

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Cell saver blood transfusions may be associated with a decrease in inflammation and improved outcome measures in

Michael J Martinez¹, Andreas Schwingshackl¹, Tahmineh Romero²

¹Division of Critical Care Medicine, Department of Pediatrics, Mattel Children's Hospital at UCLA, Los Angeles, CA, USA.

|April 12, 2022

Summary

Intraoperative cell saver (CS) transfusions in children undergoing open-heart surgery may reduce the inflammatory response and improve outcomes. This study found CS blood transfusions were associated with better renal and pulmonary function post-surgery.

Keywords:

Cardiopulmonary bypass blood transfusion cytokines inflammation operative blood salvage pediatrics

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Isolation of Endothelial Progenitor Cells from Healthy Volunteers and Their Migratory Potential Influenced by Serum Samples After Cardiac Surgery

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Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model

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Published on: September 3, 2020

Area of Science:

Cardiovascular Surgery
Pediatric Cardiology
Transfusion Medicine

Background:

Cardiopulmonary bypass (CPB) for congenital heart disease surgery triggers systemic inflammation, potentially causing acute lung and kidney injury.
Blood transfusions during CPB can worsen inflammation, increasing patient morbidity and mortality.

Purpose of the Study:

To investigate if intraoperative cell saver (CS) blood transfusions attenuate the proinflammatory cytokine response after CPB, compared to standard red blood cell transfusions.
To evaluate the impact of CS transfusions on clinical outcomes, including renal function, pulmonary function, and length of hospital stay.

Main Methods:

Serum cytokine levels (IL-10, IL-1RA, IL-6, IL-8, TNF-α) were measured preoperatively and on postoperative days 0, 1, and 2.
Clinical parameters including blood urea nitrogen (BUN), creatinine, milrinone use, extubation time, and hospital length of stay were assessed.

Main Results:

The CS group showed significantly lower anti-inflammatory IL-10 levels on postoperative day 0 compared to the control group.
Patients receiving CS transfusions had significantly lower BUN and creatinine levels on postoperative day 2.
The CS group experienced reduced milrinone use, shorter extubation times, and a decreased hospital length of stay.

Conclusions:

Intraoperative cell saver transfusions in pediatric patients may reduce the postoperative inflammatory response.
CS transfusions are associated with improved renal and pulmonary function after CPB surgery.
CS transfusions may lead to better clinical outcomes, including shorter hospital stays.