The effect of RBC transfusions on cytokine gene expression after cardiac surgery in patients developing post‐operative multiple organ failure

Sitniakowsky, L.S.; Later, Alexander F.L.; Watering, Leo M.G. van de; Bogaerts, M.; Brand, Anneke; Klautz, Robert J.M.; Smit, Nico P.M.; Hilten, J. A. van

doi:10.1111/j.1365-3148.2011.01075.x

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…This leads to multi-system and multi-cell activation and produces a large number of humoral and cellular inflammatory mediators through a cascade reaction, which eventually causes tissue and organ damage or even multiple organ dysfunction syndrome [8-10]. Causes of SIRS also include surgical injury, anesthesia, changes in body temperature, organ ischemia/reperfusion injury, machine blood transfusion, hemodilution, and heparin-protamine complexes [11,12].…”

Section: Discussionmentioning

confidence: 99%

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Liu

Zhu

et al. 2014

Eur J Med Res

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BackgroundTo compare the effect of totally thoracoscopic with conventional, open repair of atrial septal defect.MethodsForty atrial septal defect cases were divided into two groups by surgical approach: totally thoracoscopic approach (group A, n = 20) and conventional open approach (group B, n = 20). In group A, surgical procedures were performed through three portal incisions in the right lateral chest wall under thoracoscopic vision without the aid of a computerized robotic surgical system. Notably, all operations were completed by one surgeon who had just begun using this technique. In group B, the atrial septal defects were repaired in conventional open fashion. Clinical outcomes and serum levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), intercellular adhesion molecule 1 (ICAM-1), and creatine kinase isoenzyme-myocardial band (CK-MB) for the two groups were evaluated and compared.ResultsAll operations were performed successfully without serious complications. Durations of cardiopulmonary bypass (CPB), CPB setup, aortic cross-clamping, and operative procedure were significantly longer in group A than in group B (P < 0.05). The recovery times for body temperature and laboratory values of leukocytes were significantly shorter for group A than for group B (P < 0.05). There were no differences in durations of postoperative assisted ventilation or intensive care unit and hospital stays, volumes of blood transfused intraoperatively or thoracic drainage, or medical costs between the two groups. Serum levels of inflammatory factors (TNF-α, IL-6, IL-10, and ICAM-1) and CK-MB increased significantly in both groups after surgery. However, 6 h and 12 h after surgery, levels of these inflammatory factors and CK-MB were significantly lower in group A than in group B (P < 0.05).ConclusionsThoracoscopic cardiac surgery is technically feasible and safe, with less trauma and quicker recovery even when done by a surgeon newly introduced to the technique.

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Section: Discussionmentioning

confidence: 99%

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Liu

Zhu

et al. 2014

Eur J Med Res

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“…By contrast, the studies that found no effect, mixed effects, or immune‐suppressive effects associated with RBC transfusion largely employed leukoreduced RBC products . Immunosuppressive effects of transfusion have been studied most often in surgical patients .…”

Section: The Dynamic Immune Response To Critical Illnessmentioning

confidence: 99%

Transfusion‐related immunomodulation: review of the literature and implications for pediatric critical illness

et al. 2016

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Transfusion-related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients. Both hyperinflammation and severe immune suppression are associated with poor outcomes from critical illness, underscoring the need to understand potential immunologic consequences of blood product transfusion. In this review we outline the dynamic immunologic response to critical illness, provide clinical evidence in support of immunomodulatory effects of blood product transfusion, review preclinical and translational studies to date of TRIM, and provide insight into future research directions.

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“…A few studies in the literature support this notion, [35][36][37] but others do not. [38][39][40] However, no data elements in the ACS-NSQIP database allow direct measurement of inflammatory mediators or molecular markers of inflammation that permit direct inference of the association between blood transfusion and surgical infections. Our results support a relationship between surgical infections and intraoperative blood transfusion and suggest the need for further efforts to investigate the effect of blood transfusion practices on surgical infections.…”

Section: Commentmentioning

confidence: 99%

Surgical Outcomes and Transfusion of Minimal Amounts of Blood in the Operating Room

Ferraris

Davenport²,

Saha³

et al. 2012

Arch Surg

295

192

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To examine outcomes in patients who receive small amounts of intraoperative blood transfusion. Design: Longitudinal, uncontrolled observational study evaluating results of intraoperative transfusion in patients entered into the American College of Surgeons National Surgical Quality Improvement Program database. We made propensity-matched comparisons between patients who received and did not receive intraoperative transfusion to minimize confounding when estimating the effect of intraoperative transfusion on postoperative outcomes.

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The effect of RBC transfusions on cytokine gene expression after cardiac surgery in patients developing post‐operative multiple organ failure

Cited by 11 publications

References 36 publications

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Transfusion‐related immunomodulation: review of the literature and implications for pediatric critical illness

Surgical Outcomes and Transfusion of Minimal Amounts of Blood in the Operating Room

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