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Impact of Intraoperative Blood Transfusion on Cerebral Injury in Pediatric Patients Undergoing Congenital Septal
Artem Ivkin1, Evgeny Grigoriev1, Alena Mikhailova1
1Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia.
Insights
Blood transfusions during pediatric heart surgery can increase the risk of brain injury. Higher red blood cell suspension volumes correlated with biomarkers of cerebral injury and inflammation.
Area of Science:
- Pediatric Cardiology
- Neuroinflammation
- Transfusion Medicine
Background:
- Donor blood components can trigger systemic inflammation and neuroinflammation.
- This inflammation may lead to cerebral injury in pediatric patients.
Purpose of the Study:
- To determine the role of blood transfusion in cerebral injury development.
- Investigate the link between transfusion and brain injury during congenital heart defect correction.
Main Methods:
- Studied 78 pediatric patients (1-78 months old).
- Measured biomarkers of cerebral injury and systemic inflammation at three time points: pre-surgery, post-cardiopulmonary bypass, and 16 hours post-surgery.
- Analyzed correlation between transfusion volume and biomarkers.
Main Results:
- S-100β protein showed a strong correlation with transfusion volume post-bypass (Rho = 0.48) and post-surgery (Rho = 0.36).
- Neuron-specific enolase also correlated with transfusion volume post-bypass (Rho = 0.41).
- Red blood cell suspension dosage correlated with cerebral injury and inflammatory biomarkers.
Conclusions:
- Transfusion volume, specifically red blood cell suspension per kilogram, is linked to cerebral injury biomarkers.
- Transfusion practices correlate with systemic inflammatory response markers.
- Findings suggest a relationship between transfusion and neurological outcomes in pediatric cardiac surgery.
Abstract:
Background: The components of donor blood themselves have the potential to initiate a systemic inflammatory response and exacerbate neuroinflammation, resulting in subsequent cerebral injury. The aim of this study was to establish the role of transfusion in the development of cerebral injury during the correction of congenital heart defects in children. Material and Methods: A total of 78 patients aged from 1 to 78 months, with body weights ranging from 3.3 to 21.5 kg, were investigated. Biomarkers of cerebral injury and systemic inflammatory response were studied at three time points. First: prior to the surgical intervention. Second: after the completion of cardiopulmonary bypass. Third: 16 h after the conclusion of the surgery. Results: The strongest correlation was found for S-100-β protein with the volume of transfusion at the second (Rho = 0.48, p = 0.00065) and third time points (Rho = 0.36, p = 0.01330). Neuron-specific enolase demonstrated a similar trend: Rho = 0.41 and p = 0.00421 after the completion of cardiopulmonary bypass. Conclusions: The use of red blood cell suspension and its dosage per kilogram of body weight correlated with the biomarkers of cerebral injury and systemic inflammatory response with moderate to significant strength.
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