Impact of Blood Transfusions on Inflammatory Mediator Release in Patients Undergoing Cardiac Surgery

Fransen, Erik J; Maessen, Jos G.; Dentener, Mieke A.; Senden, Nicole H. M.; Buurman, Wim A.

doi:10.1378/chest.116.5.1233

Cited by 319 publications

(214 citation statements)

References 24 publications

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“…30 Stored blood also has lower concentrations of 2,3 diphosphoglycerate, which reduces oxygen delivery to peripheral tissue. 31,32 Transfusions have been reported to be associated with increased levels of proinflammatory mediators such as C-reactive protein, interleukin-6, and bactericidal permeability-increasing protein. 32 Each of these mechanisms might promote peripheral or myocardial ischemia.…”

Section: Consequences Of Transfusionmentioning

confidence: 99%

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

Wallace

Rao

2007

Clin Cardiol

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Section: Consequences Of Transfusionmentioning

confidence: 99%

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

Wallace

Rao

2007

Clin Cardiol

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“…Patients undergoing cardiac surgery manifest a noninfectious inflammatory response reflected by increased concentrations of inflammatory mediators [20]. Moreover, transfusion affects the release of inflammatory mediators [21]. Taken together, these findings support the immunosuppressive effect of blood transfusion with corresponding susceptibility to bacterial infection.…”

Section: Discussionmentioning

confidence: 69%

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

et al. 2009

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AbstractTransfusion after cardiac surgery is very common. This rate varies between institutions and has remained high despite established transfusion guidelines. We analyzed our database of patients who underwent isolated CABG (Coronary Artery Bypass Graft) to determine the predictive factors of homologous transfusion and associated postoperative morbidity, mortality and resource utilization. All 14,152 patients who underwent first-time isolated CABG, with or without cardiopulmonary bypass (CPB) who had postoperative homologous transfusion between February 2002 and March 2008 in Tehran Heart Center, were evaluated retrospectively. Overall, 16.5% of patients received transfusion. Transfused patients demonstrated a significantly higher incidence of postoperative complications (cardiac, infectious, ischemic, reoperation) and mortality (p<0.001). Homologous blood transfusion effect on mortality, morbidity and resource utilization. By Multivariable logistic regression analysis adjusted for confounders: Homologous blood transfusion effect on Mortality (30-days) (OR=3.976, p<0.0001), Prolonged ventilation hours (OR=4.755, p<0.0001), Total ICU hours (β =14.599, p<0.0001), Hospital length of stay (β =1.141, p<0.0001), Post surgery length of stay (β =0.955, p<0.0001). We conclude that the isolated CABG patients receiving blood transfusion have significantly higher mortality, morbidity and resource utilization. Homologous blood transfusion is an independent factor of increased resource utilization, morbidity and mortality.

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“…[20] In patients with other active organic problems in addition to this inflammatory activity, such as AKI, lung injury, or sepsis and in patients with a high blood transfusion rate, prolonged ventilation time, and re-exploration in the postoperative period, postoperative morbidity and mortality increase. [20,21] There are several studies showing that postoperative AKI is associated with worse postoperative early and late outcomes. [3] Patients with AKI in the postoperative period have a higher infection and sepsis rate with longer intensive care unit stay and higher mortality rate, while they need more intra-aortic balloon pump and inotropic support.…”

Section: Discussionmentioning

confidence: 99%

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

İşcan¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada izole kalp kapak cerrahisi sonrası akut böbrek hasarının prevalansı araştırıldı ve risk faktörleri ve bir yıllık takip sonuçları belirlendi.Ça lış ma pla nı: Ocak 2008 -Aralık 2014 tarihleri arasında aort ve mitral kapak cerrahisi yapılan toplam 220 hasta (106 erkek, 114 kadın; ort. yaş 50.6±14.7 yıl; dağılım 14-79 yıl) retrospektif olarak incelendi. Hastaların başlangıç özellikleri, eşlik eden hastalıkları, cerrahi parametreleri ve cerrahi sonrası sonuçları kaydedildi. Hastalar Akut Böbrek Hasarı Ağı Kriterleri kullanılarak cerrahi öncesi ve sonrası kreatinin değerleri ile değerlendirildiği üzere, akut böbrek hasarı olanlar ve olmayanlar olarak iki gruba ayrıldı. Bul gu lar:Tüm hastaların 57'sinde akut böbrek hasarı gelişti. Bu hastaların 12'sinde hemodiyaliz ihtiyacı oldu (evre 1, n=40; evre 2, n=12; evre 3, n=5). Akut böbrek hasarı gelişen hastalar, daha yüksek diabetes mellitus oranı ile daha yaşlı olma eğilimindeydi. Bu hastalarda cerrahi sonrası sepsis, kanama revizyonu, atriyal fibrilasyon ve intraaortik balon pompası ihtiyacı oranları daha yüksek ve yoğun bakım ünitesinde ve hastanede kalış süresi daha uzundu. Akut böbrek hasarı gelişmeyen hastalara kıyasla, gelişen hastalarda, daha fazla eritrosit transfüzyonu gerekli oldu.So nuç: Çalışma sonuçlarımız, Akut Böbrek Hasarı Ağı kriterlerine göre cerrahi sonrası hafif düzeyde kreatinin değişiklikleri ile tanılanan akut böbrek hasarının prognoz açısından önemli bir komplikasyon olduğunu göstermektedir. Yaş, diabetes mellitus ve kan transfüzyonu cerrahi sonrası akut böbrek hasarının başlıca risk faktörleridir. Kalp cerrahisi ile ilişkili akut böbrek hasarının erken ve geç dönem sonuçlarının önlenmesi için hastalar cerrahi öncesinde dikkatlice değerlendirilmelidir.Anah tar söz cük ler: Akut böbrek hasarı; kalp kapak cerrahisi; cerrahi sonrası morbidite. ABSTRACTBackground:This study aims to investigate the prevalence of acute kidney injury after isolated cardiac valve surgery, and to identify risk factors and one-year follow-up results.

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Impact of Blood Transfusions on Inflammatory Mediator Release in Patients Undergoing Cardiac Surgery

Cited by 319 publications

References 24 publications

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

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