Difference in autologous blood transfusion-induced inflammatory responses between acute normovolemic hemodilution and preoperative donation

Kotake, Yoshifumi; Yamamoto, Michiko; Matsumoto, Midori; Yamada, Takashige; Nagata, Hiromasa; Morisaki, Hiroshi; Takeda, Junzo

doi:10.1007/s00540-008-0706-3

Cited by 3 publications

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“…RBC transfusions could increase postoperative pneumonia in patients undergoing CABG surgery [ 17 ]. Second, ANH blood was associated with a smaller concentration of inflammatory mediators such as interleukin-10 and neutrophil elastase than predonated autologous blood [ 30 ]. Third, due to the hemodilution-induced blood viscosity, such protection might be associated with an improved oxygen supply-consumption balance [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Mild volume acute normovolemic hemodilution is associated with lower intraoperative transfusion and postoperative pulmonary infection in patients undergoing cardiac surgery -- a retrospective, propensity matching study

et al. 2017

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BackgroundPerioperative allogenic transfusion is required in almost 50% of patients undergoing cardiac surgery and is associated with higher risk of mortality and morbidity (Xue et al., Lancet 387:1905, 2016; Ferraris et al., Ann Thorac Surg 91:944–82, 2011). Acute normovolemic hemodilution (ANH) is recommended as a potential strategy during cardiac surgery, but the blood conservation effect and the degree of ANH was still controversial. There is also an increasing concern about the improved outcomes associated with ANH. Therefore, a better understanding of the effect of mild volume ANH during cardiac surgery is urgently needed.MethodsThis retrospective study included 2058 patients who underwent cardiac surgery between 2010 and 2015. The study population was split into two groups (with and without mild volume ANH). Propensity score adjustment analysis was applied. We reported the association between the use of mild volume ANH and perioperative outcomes.ResultsA total of 1289 patients were identified. ANH was performed in 358 patients, and the remaining 931 patients did not receive any ANH. Five hundred of the total patients (38.8%) received perioperative RBC transfusions, 10% (129/1289) of patients received platelet, and 56.4% (727/1289) of patients received fresh frozen plasma transfusions. Mild volume ANH administration was significantly associated with decreased intraoperative RBC transfuse rate (8.5% vs. 14.4%; p = 0.013), number of RBC units (p = 0.019), and decreased postoperative pulmonary infection (6.8 vs. 11.3%; p = 0.036) during cardiac surgery. However, there was no significant difference regarding intraoperative fresh frozen plasma (FFP) and platelet concentrate transfusions, as well as postoperative and total perioperative allogeneic transfusions. Furthermore, there was no significant difference regarding postoperative outcomes including mortality, prolonged wound healing, stroke, atrial fibrillation, reoperation for postoperative bleeding and acute kidney injury. There was also no difference in postoperative ventilation time, length of ICU and hospital stay.ConclusionBased on the 5-year experience of mild volume ANH in cardiac surgeries with CPB in our large retrospective cohort, mild volume ANH was associated with decreased intraoperative RBC transfusion and postoperative pulmonary infection in Chinese patients undergoing cardiac surgery. However, there was no significant difference regarding postoperative and total perioperative allogeneic transfusions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0305-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Mild volume acute normovolemic hemodilution is associated with lower intraoperative transfusion and postoperative pulmonary infection in patients undergoing cardiac surgery -- a retrospective, propensity matching study

et al. 2017

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“…As substâncias biológicas liberadas pelos componentes do sangue durante o processo de estocagem da bolsa sanguínea podem apresentar um papel fundamental no estabelecimento dos efeitos adversos da transfusão (Jensen et al, 1996;Weisbach et al, 1999;Kotake et al, 2009). Por exemplo, previamente creditava-se como causa da reação transfusional não-hemolítica febril uma reação do sistema imune contra os leucócitos do doador.…”

Section: Um Estudo Observacional Multicêntrico (Anemia and Blood Tranunclassified

“…Até o presente momento, muitos estudos foram conduzidos acerca de choque hemorrágico e inflamação (Rhee et al, 1998;Watters et al, 2004;Alam et al, 2004;Lee et al, 2005;Chen et al, 2005;Bahrami et al, 2006), sepse e inflamação (Zhang et al, 2003;Martins et al, 2003;Lv et al, 2006;Di Filippo et al, 2006;Feng et al, 2007;Martins et al, 2008) sendo que poucas pesquisas constam na literatura sobre hemodiluição e resposta inflamatória (Peillon et al, 1995;Wolowczyk et al, 2005). Kotake et al (2009) observaram em um estudo clínico que não houve diferenças entre as técnicas de hemodiluição normovolêmica aguda e pré-doação de sangue autólogo com relação aos mediadores inflamatórios após a transfusão de sangue previamente coletado com uma das técnicas. A principal diferença encontrada neste estudo foi em relação ao período de estocagem da bolsa, sendo de 3,7 horas e 6,1 dias para HNA e pré-doação, respectivamente, fato que resultou em maior liberação de elastase neutrofílica e IL-10 na bolsa de sangue advinda da técnica de pré-doação.…”

Section: Um Estudo Observacional Multicêntrico (Anemia and Blood Tranunclassified

Avaliação da resposta inflamatória durante a hemodiluição normovolêmica aguda

Kahvegian¹

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Ao meu marido Renato, companheiro de todas as horas, pelo amor, tolerância e paciência. Ao meu irmão Marcos e minha avó Almasia pelo amor, incentivo e apoio. Aos meus pais, Antônio Carlos e Regina pela formação e educação proporcionada. Agradecimentos À Profa. Dra. Denise Tabacchi Fantoni pela inestimável orientação na realização deste trabalho, pelos ensinamentos e pela paciência. Ao Prof. Dr. José Otávio Costa Auler Jr. pelo apoio e confiança. À amiga Denise Aya Otsuki pela colaboração incomensurável, incentivo e amizade. À amiga Cristina Massoco pelos ensinamentos, idéias brilhantes, estímulo e colaboração no estudo. À Carla Holms pela imensa colaboração durante a fase experimental, fato que possibilitou a realização deste estudo. Ao Sr. Gilberto Nascimento pelo auxílio no Laboratório LIM 08 durante a fase experimental. À Fundação de Amparo à Pesquisa do Estado de São Paulo-FAPESP-pelo apoio financeiro concedido e que possibilitou a realização deste estud.

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A humoral solution: Autologous blood products and tissue repair

Yogev

2020

Cellular Immunology

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Difference in autologous blood transfusion-induced inflammatory responses between acute normovolemic hemodilution and preoperative donation

Abstract: Inflammatory mediators were significantly increased in PD blood during storage compared to the blood obtained by ANH. However, their effects on the inflammatory response elicited in the recipients were not significantly different.

Cited by 3 publications

References 30 publications

Mild volume acute normovolemic hemodilution is associated with lower intraoperative transfusion and postoperative pulmonary infection in patients undergoing cardiac surgery -- a retrospective, propensity matching study

Mild volume acute normovolemic hemodilution is associated with lower intraoperative transfusion and postoperative pulmonary infection in patients undergoing cardiac surgery -- a retrospective, propensity matching study

Avaliação da resposta inflamatória durante a hemodiluição normovolêmica aguda

A humoral solution: Autologous blood products and tissue repair

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