The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 101-59-87
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2024
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Ivkin A.A.

Research Institute for Complex Issues of Cardiovascular Diseases

Borisenko D.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Tsepokina A.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Grigoriyev E.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Shukevich D.L.

Research Institute for Complex Issues of Cardiovascular Diseases

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

Authors:

Ivkin A.A., Borisenko D.V., Tsepokina A.V., Grigoriyev E.V., Shukevich D.L.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2021;(4): 54‑61

DOI: 10.17116/anaesthesiology202104154

Views: 587

Downloaded: 38

Download PDF (RU)
Contact the author
Table of contents

To cite this article:

Ivkin AA, Borisenko DV, Tsepokina AV, Grigoriyev EV, Shukevich DL. Renouncement of red blood cells for heart-lung machine filling for perioperative prevention of cerebral injury in children undergoing cardiac surgery. Russian Journal of Anesthesiology and Reanimatology. 2021;(4):54‑61. (In Russ.)
https://doi.org/10.17116/anaesthesiology202104154

Подписка 2025 (АиР)
МСФ на ЯМ
Close metadata
Recommended articles:
Histological evaluation of esophageal stri­cture in children with caustic burn. Piro­gov Russian Journal of Surgery. 2023;(12):43-51
Reco­nstruction of total portosystemic shunt into sele­ctive portosystemic shunt in a child. Piro­gov Russian Journal of Surgery. 2023;(12):140-146
Prognostic value of outpatient endo­scopy for the diagnosis of eosi­nophilic esophagitis in children. Russian Journal of Evidence-Based Gastroenterology. 2023;(4):5-10
Gastritis and gastroesophageal reflux disease in schoolchildren from ethnic groups in the Repu­blic of Tuva. Russian Journal of Evidence-Based Gastroenterology. 2023;(4):36-42
Robot-assisted cholecystectomy in children. Endo­scopic Surgery. 2023;(6):82-88
Proximal ureterouretheroanastomosis in the treatment of kidney double in children. Endo­scopic Surgery. 2023;(6):103-110
Evaluation of the possibility of diagnosing puru­lent-septic rhinogenic complications of the orbit and eyelids in children based on the analysis of clinical and labo­ratory data. Russian Bulletin of Otorhinolaryngology. 2023;(6):56-60
Thoracoscopic tracheal rese­ction in a child under extracorporeal membrane oxygenation. Piro­gov Russian Journal of Surgery. 2024;(1):86-90
Obesity-associated asthma phenotype in children. Russian Journal of Preventive Medi­cine. 2024;(1):106-114
The high-intensity pulsed magnetic therapy in the medi­cal reha­bilitation of children. (Literature review). Problems of Balneology, Physiotherapy and Exercise Therapy. 2023;(6):99-102

Surgery for congenital heart defects (CHD) is performed under cardiopulmonary bypass and accompanied by various factors affecting the child’s brain. However, there are currently few studies devoted to prevention of cerebral damage in children undergoing cardiac surgery.

OBJECTIVE

To establish the effect of renouncement of red blood cells for heart-lung machine filling to prevent cerebral damage in children with septal congenital heart disease undergoing on-pump cardiac surgery.

MATERIAL AND METHODS

The study included 40 children aged 14 [12-22.5] months. Mean weight of children was 8.8 [7.25-11] kg. All patients underwent radical correction of septal CHD under cardiopulmonary bypass. All patients were divided into 2 groups depending on the use of red blood cells for primary filling of heart-lung machine. Cerebral damage was assessed using 3 specific serum markers: protein S100β, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP) prior to surgery, after CPB and in 16 hours after surgery. Clinical assessment of cerebral injury was carried out using the Cornell Pediatric Delirium Assessment scale.

RESULTS

We analyzed certain intra- and postoperative factors: hemoglobin, oxygen transport indicators (cerebral oxygenation, lactate and venous saturation) and parameters of organ dysfunction (creatinine, urea, bilirubin, duration of artificial lung ventilation and ICU-stay). No between-group differences were found and all indicators were within the reference values. Thus, correction of congenital heart defects without transfusion is safe. In addition, concentration of specific markers of brain damage was significantly higher in the group of transfusion after CPB weaning: S100β — 522.1 [386.65-702.9] ng/L and 947.7 [696.93-1378.25] ng/L (p<0.001); NSE — 30.51 [22.8-36.99] ng/L and 44.92 [34.1-55.06] ng/L (p=0.007); GFAP — 0.1172 [0.1093-0.1198] ng/ml and 0.1238 [0.1195-0.1348] ng/ml (p=0.004). In addition, GFAP was higher in the same group in 16 hours after surgery — 0.11 [0.105-0.1197] ng/ml and 0.1212 [0.1177-0.1404] ng/ml (p=0.002).

CONCLUSION

Rejection of red blood cells for heart-lung machine filling is safe for prevention of cerebral injury.

Keywords:

children
congenital heart defects
cardiac surgery
cardiopulmonary bypass
neurovascular unit
cerebral injury

Authors:

Ivkin A.A.

Research Institute for Complex Issues of Cardiovascular Diseases

Borisenko D.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Tsepokina A.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Grigoriyev E.V.

Research Institute for Complex Issues of Cardiovascular Diseases

Shukevich D.L.

Research Institute for Complex Issues of Cardiovascular Diseases

Received:

01.01.2021

Accepted:

03.04.2021

List of references:

  1. Kaushal V, Schlichter LC. Mechanisms of microglia-mediated neurotoxicity in a new model of the stroke penumbra. Journal of Neuroscience. 2008;28(9):2221-2230. https://doi.org/10.1523/JNEUROSCI.5643-07.2008
  2. Torbett BE, Baird A, Eliceiri BP. Understanding the rules of the road: proteomic approaches to interrogate the blood brain barrier. Frontiers in Neuroscience. 2015;4(9):70.  https://doi.org/10.3389/fnins.2015.00070
  3. Shrader NI, Shaybakova VL, Likhvantsev VV, Levikov DI, Levin OS. Neurological complications of coronary artery bypass grafting. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2012;112(3):76-81. (In Russ). https://doi.org/10.1007/s11055-013-9796-y
  4. Guenther U, Theuerkauf N, Frommann I, Brimmers K, Malik R, Stori S, Scheidemann M., Putensen C., Popp J.. Predisposing and precipitating factors of delirium after cardiac surgery. A prospective observational cohort study. Annals of Surgery. 2013;257(6):1160-1167. https://doi.org/10.1097/sla.0b013e318281b01c
  5. Ramlawi B, Rudolph JL, Mieno S, Khabbaz K, Sodha NR, Boodhwani M, Levkoff SE, Marcantonio ER, Sellke FW. Serologic markers of brain injury and cognitive function after cardiopulmonary bypass. Annals of Surgery. 2006;244(4):593-601.  https://doi.org/10.1097/01.sla.0000239087.00826.b4
  6. Stehouwer MC, Boers C, de Vroege R, C Kelder J, Yilmaz A, Bruins P. Clinical evaluation of the air removal characteristics of an oxygenator with integrated arterial filter in a minimized extracorporeal circuit. The International Journal of Artificial Organs. 2011;34(4):374-382.  https://doi.org/10.5301/ijao.2011.7749
  7. Grigore AM, Murray CF, Ramakrishna H, Djaiani G. A core review of temperature regimens and neuroprotection during cardiopulmonary bypass: does rewarming rate matter? Anesthesia and Analgesia. 2009;109(6):1741-1751. https://doi.org/10.1213/ANE.0b013e3181c04fea
  8. Jirschik M, Keyl C, Beyersdorf F. A clinical comparison of bubble elimination in Quadrox and Polystan oxygenators. Perfusion. 2009;24(6):423-437.  https://doi.org/10.1177/0267659109358206
  9. Hirata Y. Cardiopulmonary bypass for pediatric cardiac surgery. General Thoracic and Cardiovascular Surgery. 2018;66(2):65-70.  https://doi.org/10.1007/s11748-017-0870-1
  10. Nellis ME, Goel R, Feinstein S, Shahbaz S, Kaur S, Traube C. Association between transfusion of RBCs and subsequent development of delirium in critically ill children. Pediatric Critical Care Medicine. 2018;19(10):925-929.  https://doi.org/10.1097/PCC.0000000000001675
  11. Rothoerl RD, Brawanski A, Woertgen C. S100B protein serum levels after controlled cortical impact injury in the rat. Acta Neurochirurgica. 2001;142(2):199-203.  https://doi.org/10.1007/s007010050024
  12. Beer C, Blacker D, Bynevelt M, Hankey GJ, Puddey IB. Systemic markers of inflammation are independently associated with S100B concentration: results of an observational study in subjects with acute ischaemic stroke. Journal of Neuroinflammation. 2010;7:71.  https://doi.org/10.1186/1742-2094-7-71
  13. Rabinowicz AL, Correale J, Boutros RB, Couldwell WT, Henderson CW, DeGiorgio CM. Neuronspecific enolase is increased after single seizures during inpatient video/EEG monitoring. Epilepsia. 1996;37(2):122-125.  https://doi.org/10.1111/j.1528-1157.1996.tb00002.x
  14. Lasek-Bal A, Jedrzejowska-Szypulka H, Student S, Warsz-Wianecka A, Zareba K, Puz P, Bal W, Pawletko K, Lewin-Kowalik J. The importance of selected markers of inflammation and blood-brain barrier damage for short-term ischemic stroke prognosis. Journal of Physiology and Pharmacology. 2019;70(2):10.26402/jpp.2019.2.04.  https://doi.org/10.26402/jpp.2019.2.04
  15. Pekny M, Wilhelmsson U, Pekna M. The dual role of astrocyte activation and reactive gliosis. Neuroscience Letters. 2014;565:30-38.  https://doi.org/10.1016/j.neulet.2013.12.071
  16. Silver G, Kearney J, Traube C, Hertzig M. Delirium screening anchored in child development: The Cornell Assessment for Pediatric Delirium. Palliative and Supportive Care. 2015;13(4):1005-1011. https://doi.org/10.1017/S1478951514000947
  17. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, Tesoro EP, Elswick RK. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. American Journal of Respiratory and Critical care Medicine. 2002;166(10):1338-1344. https://doi.org/10.1164/rccm.2107138
  18. Kain ZN, Mayes LC, Cicchetti DV, Bagnall AL, Finley JD, Hofstadter MB. The Yale Preoperative Anxiety Scale: how does it compare with a “gold standard”? Anesthesia and Analgesia. 1997;85(4):783-788.  https://doi.org/10.1097/00000539-199710000-00012
  19. Trukhacheva NV. Matematicheskaya statistika v mediko-biologicheskikh issledovaniyakh s primeneniem paketa Statistica. M.: GEOTAR-Media; 2013. (In Russ.).
  20. Clark RK, Lee EV, Fish CJ, White RF, Price WJ, Jonak ZL, Feuerstein GZ, Barone FC. Development of tissue damage, inflammation and resolution following stroke: an immunohistochemical and quantitative planimetric study. Brain Research Bulletin. 1993;31(5):565-572.  https://doi.org/10.1016/0361-9230(93)90124-t
  21. Yao FSF, Tseng CCA, Ho CYA, Levin SK, Illner P. Cerebral oxygen desaturation is associated with early post- operative neuropsychological dysfunction in patients undergoing cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia. 2004;18(5):552-558.  https://doi.org/10.1053/j.jvca.2004.07.007
  22. Panch SR, Montemayor-Garcia C, Klein HG. Hemolytic Transfusion Reactions. The New England Journal of Medicine. 2019;381(2):150-162.  https://doi.org/10.1056/NEJMra1802338
  23. Pozhilenkova EA, Lopatina OL, Komleva YK, Salmin VV, Salmina AB. Blood-brain barrier-supported neurogenesis in healthy and diseased brain. Reviews in the Neurosciences. 2017;28(4):397-415.  https://doi.org/10.1515/revneuro-2016-0071
  24. Delaney M, Stark PC, Suh M, Triulzi DJ, Hess JR, Steiner ME, Stowell CP, Sloan SR. The Impact of Blood Component Ratios on Clinical Outcomes and Survival. Anesthesia and Analgesia. 2017;124(6):1777-1782. https://doi.org/10.1213/ANE.0000000000001926
  25. Jönsson H, Johnsson P, Höglund P, Alling C, Blomquist S. Elimination of S100B and renal function after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia. 2000;14(6):698-701.  https://doi.org/10.1053/jcan.2000.18444
  26. Larionov MV, Trubnikova OA, Plotnikov GP, Grigoryev EV, Shukevich DL. Justification of the choice of anesthetics to protect the brain and prevent cognitive decline during coronary bypass surgery. Meditsina v Kuzbasse. 2015;14(3):43-51. (In Russ.).
  27. Patel AK, Biagas KV, Clarke EC, Gerber LM, Mauer E, Silver G, Chai P, Corda R, Traube C. Delirium in Children After Cardiac Bypass Surgery. Pediatric Critical Care Medicine. 2017;18(2):165-171.  https://doi.org/10.1097/PCC.0000000000001032
  28. Calderon J, Bellinger DC. Executive function deficits in congenital heart disease: why is intervention important? Cardiology in the Young. 2015; 25(7):1238-1246. https://doi.org/10.1017/S1047951115001134
  29. Alvarez RV, Palmer C, Czaja AS, Peyton C, Silver G, Traube, Mourani PM, Kaufman J. Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit. The Journal of Pediatrics. 2018;195: 206-212.  https://doi.org/10.1016/j.jpeds.2017.11.064
  30. Ivkin AA, Kornelyuk RA, Borisenko DV, Nokhrin AV, Shukevich DL. Artificial blood circulation without donor blood components during heart surgery in a child weighing 8 kg. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2018;20(2):62-67. (In Russ.). https://doi.org/10.21688/1681-3472-2018-2-63-67

Close metadata

Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register


We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.