Cardiopulmonary bypass without the use of donor blood components in heart surgery in an 8-kg infant: case report

Ивкин, А. А.; Корнелюк, Р. А.; Борисенко, Д. В.; Нохрин, А. В.; Шукевич, Д. Л.

doi:10.21688/1681-3472-2018-2-63-67

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Не менее остро в хирургии ВПС стоит вопрос применения препаратов донорской крови и кровосберегающих технологий, в том числе обсуждаемый в отечественной литературе [3]. Причина данной проблемы в повышенной кровопотере в интра-и послеоперационном периоде кардиохирургических операций и специфической для детей особенности -добавлении компонентов донорской крови в объем первичного заполнения аппарата ИК как метода профилактики критической гемодилюции.…”

Section: Introductionunclassified

“…Для оценки кислородной емкости крови выполнено сравнение уровня гемоглобина и гематокрита в группах больных. Так, уровень гемоглобина как во время ИК (87 г/л [81-91,3] и 92 г/л [87,3]; р = 0,008), так и в конце операции (106 г/л [101,3] и 130,5 г/л [104-125,5]; р˂0,001) преобладал в контрольной группе с применением трансфузии. Аналогичное соотношение в пользу контрольной группы наблюдалось и при рассмотрении уровня гематокрита: 25,5% [24-27] и 29% [27,8-31] (р˂0,001) во время ИК; 31,5% [30-33,3] и 40% [38,8-41,5] (р˂0,001) в конце оперативного вмешательства.…”

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Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

Ивкин

Борисенко

Grigoriev

2021

Kompleks. probl. serdečno-sosud. zabol.

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Aim. To establish the role of donor blood components which are used in the intraoperative period in children with septal congenital heart disease (CHD) who need surgical interventions with cardiopulmonary bypass (CPB) for the prevention of cerebral injury in the postoperative period.Methods. 40 children of 14 months old on average and 8.8 kg of weight were under the study. All patients underwent radical correction of the septal CHD with the use of CPB. The patients were divided into 2 groups according to the donated blood components used. Cerebral damage was assessed with the help of three specific markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP). The severity of the systemic inflammatory response was defined by the level of the following markers: interleukin 1, 6 and 10 in serum before operations, after the completion of IC and 16 hours after surgery. The clinical analysis of cerebral injury was performed via the Cornell Assessment for Pediatric Delirium.Results. Statistically the concentration of all three markers of cerebral injury was significantly higher in the transfusion group after the end of CPB. Similar dynamics was observed in the concentrations of interleukins. In addition, the values for GFAP were higher in the transfusion group and 16 hours after surgery.Conclusion. The safety and effectiveness of the strategy on refusal of intraoperative transfusion in order to prevent cerebral injury in children during the correction of septal CHD has been demonstrated.

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Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

Ивкин

Борисенко

Grigoriev

2021

Kompleks. probl. serdečno-sosud. zabol.

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The Eﬀect of Erythrocyte-Containing Donor Blood Components in the Priming of the Cardiopulmonary Bypass Circuit on the Development of Systemic Inﬂammation During Correction of Congenital Heart Defects in Children

Борисенко

Ивкин

Шукевич

et al. 2022

Obŝaâ reanimatologiâ

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Various pathological factors accompanying any cardiac surgery can cause intraoperative systemic inﬂammatory responses (SIR). As the number of cardiac surgical interventions grows worldwide, the issue of SIR prevention appears highly relevant.Aim of the study. To determine the eﬀect of not using donor blood components in the priming of the cardiopulmonary bypass circuit in children with septal congenital heart defects, operated under cardiopulmonary bypass, on the severity of SIR.Material and methods. A prospective, randomized study included 40 children with a median age of 14 [12–22.5] months and weight of 8.8 [7.25–11] kg. All patients underwent radical correction of septal defect under cardiopulmonary bypass. The patients were divided into two groups depending on the use of donor blood components for priming the CPB. The severity of SIR was assessed using four speciﬁc serum biomarkers such as interleukin 1b (IL-1b), interleukin 6 (IL-6), interleukin 10 (IL-10), and tumor necrosis factor alpha (TNF-α), measured before the operation, after the CPB and 16 hours after the surgery. In addition, the intra- and postoperative periods were evaluated.Results. The safety of the proposed strategy of skipping the donor blood was confirmed by lack of any organ dysfunction in all patients, as well as a significant difference in the balance of oxygen delivery and consumption. In addition, the levels of systemic inflammation markers after CPB were significantly higher in patients who had transfusion: IL-1b was 3.3 [3.2–3.48] pg/mL vs 2.86 [2.7–3.11] pg/mL (P=0.003) and TNF-α reached 1.81 [1.37–3.3] pg/mL vs 1.33 [1.26–1.76] pg/mL (P=0.034). Meanwhile, 16 hours post surgery, IL-6 and IL-10 levels were significantly higher in the group using donor blood components with IL-6 being 48.91 [33.89–57.6] pg/mL vs 31.56 [26.83–48.89] pg/mL (P=0.087) and IL-10 reaching 0.8 [0.76–1.43] pg/mL vs 0.69 [0.6–0.83] pg/mL (P=0.005).Conclusion. The study demonstrates and conﬁrms the safety and eﬃcacy of cardiopulmonary bypass without using donor blood components to reduce the severity of the systemic inﬂammatory response in children undergoing correction of septal congenital heart defects.

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Renouncement of red blood cells for heart-lung machine filling for perioperative prevention of cerebral injury in children undergoing cardiac surgery

Ивкин¹,

Борисенко²,

Цепокина³

et al. 2021

Anaes. i reanim.

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Cardiopulmonary bypass without the use of donor blood components in heart surgery in an 8-kg infant: case report

Cited by 4 publications

References 6 publications

Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children

The Eﬀect of Erythrocyte-Containing Donor Blood Components in the Priming of the Cardiopulmonary Bypass Circuit on the Development of Systemic Inﬂammation During Correction of Congenital Heart Defects in Children

Renouncement of red blood cells for heart-lung machine filling for perioperative prevention of cerebral injury in children undergoing cardiac surgery

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