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

Ивкин, А. А.; Борисенко, Д. В.; Цепокина, А. В.; Grigoryev, E. V.; Шукевич, Д. Л.

doi:10.17116/anaesthesiology202104154

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…Тренды развития современной кардиохирургии и кардиоанестезиологии у детей направлены на снижение объема вмешательства, времени анестезии и искусственного кровообращения. Все это вкупе с мерами по ограничению системного воспалительного ответа (ультрафильтрация, ограничение трансфузии, модификации искусственного кровообращения) должно приводить к снижению выраженности церебрального повреждения [1,8]. Однако частота развития послеоперационных когнитивных нарушений остается высокой.…”

Section: Introductionunclassified

The importance of ketamine for cerebral protection in pediatric cardiac surgery

Ivkin,

Grigoriev

2024

Vestn. anesteziol. reanimatol.

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The problem of cerebral protection in cardiac surgery is relevant, despite all the techniques used. Due to its properties, ketamine can occupy its niche in solving this problem. The article analyzes current literature sources and describes the use of ketamine for analgesia, sedation and cerebral protection, and analyzes its properties for reducing the systemic inflammatory response. The mechanisms of its action and recommended doses are given, and schemes for its use both during anesthesia and the postoperative period are presented.

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Section: Introductionunclassified

The importance of ketamine for cerebral protection in pediatric cardiac surgery

Ivkin,

Grigoriev

2024

Vestn. anesteziol. reanimatol.

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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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Substantiation of protection of a neurovascular unit in the clinical model of cardiopulmonary bypass

Ивкин

Grigoryev

Моргун

2023

Kompleks. probl. serdečno-sosud. zabol.

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This analytical review presents data on brain injury in surgical management of congenital heart disease. A brief description of mechanisms of brain injury and methods of its prevention are given, moreover, a clinical case applying such techniques is given. The neurovascular unit in vitro model and its advantages are presented. The protocol for modelling, the further application of the model, and the prospects of using it for studying intraoperative hypoxia and systemic inflammatory response on the patient`s brain are described.

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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

Cited by 4 publications

References 28 publications

The importance of ketamine for cerebral protection in pediatric cardiac surgery

The importance of ketamine for cerebral protection in pediatric cardiac surgery

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

Substantiation of protection of a neurovascular unit in the clinical model of cardiopulmonary bypass

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