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预处理储存红细胞对接受心脏矫正手术的新生儿的影响。

The effect of preprocessing stored red blood cells on neonates undergoing corrective cardiac surgery.

作者信息

Liu Jinping, Ji Bingyang, Feng Zhengyi, Zhao Ju, Li Chunhua, Li Bo, Long Cun

机构信息

Department of Cardiopulmonary bypass, Cardiovascular Institute and Fuwai Hospital, PUMC & CAMS, Beijing, China.

出版信息

ASAIO J. 2007 Nov-Dec;53(6):680-3. doi: 10.1097/MAT.0b013e31815a5edb.

DOI:10.1097/MAT.0b013e31815a5edb
PMID:18043146
Abstract

This study compared the effect of unprocessed and processed packed red blood cells (PRBCs) with the continuous autotransfusion system (CATS) during neonate heart surgery. Sixteen neonatal patients undergoing cardiac surgery were randomly divided into two groups: unprocessed PRBC (C group, n = 8); processed PRBC (P group, n = 8). The CATS was employed perioperatively. Series laboratory and clinical parameters, including levels of hematocrit, blood potassium, blood glucose, blood lactate, acid-base, and total priming volume of PRBC, were used to compare the effect between the two groups. Before CPB, the hematocrit of processed PRBCs in P group was significantly higher than those in C group (p < 0.01), and the concentrations of potassium, blood glucose, and lactate of processed PRBCs in P group were significantly lower than those in C group (p < 0.01). At the beginning and the end of CPB, the hematocrit levels in P group were all higher than those in C group (p < 0.05); lactate levels in P group were significantly lower than those in C group at the beginning of CPB (p < 0.01), and lower than that of C group at the end of CPB (p < 0.05). The total priming of PRBCs in P group was significantly less than that in C group (p < 0.01). Perioperative processing with CATS provided a high-quality RBC concentration, decreased the total priming of PRBCs, providing increased high-quality blood salvage during neonatal CPB procedure.

摘要

本研究比较了未处理和处理过的浓缩红细胞(PRBCs)与连续自体输血系统(CATS)在新生儿心脏手术中的效果。16例接受心脏手术的新生儿患者被随机分为两组:未处理的PRBC组(C组,n = 8);处理过的PRBC组(P组,n = 8)。术中使用CATS。一系列实验室和临床参数,包括血细胞比容、血钾、血糖、血乳酸、酸碱值以及PRBC的总预充量,用于比较两组之间的效果。体外循环(CPB)前,P组处理过的PRBC的血细胞比容显著高于C组(p < 0.01),且P组处理过的PRBC的钾、血糖和乳酸浓度显著低于C组(p < 0.01)。CPB开始时和结束时,P组的血细胞比容水平均高于C组(p < 0.05);CPB开始时P组的乳酸水平显著低于C组(p < 0.01),CPB结束时低于C组(p < 0.05)。P组PRBC的总预充量显著少于C组(p < 0.01)。术中使用CATS进行处理可提供高质量的红细胞浓度,减少PRBC的总预充量,在新生儿CPB过程中增加高质量的血液回收。

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