Methods of Molecular Transfusion in Intensive Care of Critical States in Pediatric Postoperative Cardiac Surgery Patients

Abstract

Molecular techniques in transfusion medicine have become popular in the clinical practice of pediatric intensive care units when the patient needs blood purification, more recently, in children in critical condition. Considering the anatomical and physiological characteristics of the child’s body, pronounced severity, and rapid progression of multiple organ disorders, the key problems defining the treatment results are instrument reading, choice and timely initiation of extracorporeal therapy. Today, along with the methods of renal replacement therapy in children albumin dialysis therapy and high-volume plasmapheresis are successfully applied in the treatment of acute liver dysfunction; extracorporeal membrane oxygenation — in the treatment of biventricular cardiac and/or respiratory failure. Selective endotoxin sorption methods (LPS-adsorption) are implemented in the treatment of severe gram-negative sepsis.

Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

“…[26,38] However, the albumin loss during Prometheus-therapy can reach 3 g/L (P = 0.055). [31,39] We observed no significant negative dynamics of serum albumin [oscillations: 32 (30-35) and 30 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35) g/L, P = 0.052, before and after MARS-therapy; 33 (31-34) and 31 (28-36) g/L, P = 0.051, before and after Prometheus-therapy], which is probably due to the adequate routine correction of hypoproteinemia in patients with ALF. [39] Likewise, despite published data on the loss of coagulation factors during Prometheus-therapy, [40] we did not observe clinically significant hemorrhagic complications.…”

“…[30,31] The experience from implementing this therapy in adults allows the use of extracorporeal liver support to be recommended in pediatric practice. [32][33][34] MARS-therapy is a method of albumin dialysis that uses a filter permeable to substances with a molecular weight of up to 50 kDa. The toxins accumulated on the filter membrane are subsequently bound to the donor albumin used as a dialysate.…”