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术中输血对先天性房间隔缺损手术患儿脑损伤的影响。

Impact of Intraoperative Blood Transfusion on Cerebral Injury in Pediatric Patients Undergoing Congenital Septal Heart Defect Surgery.

作者信息

Ivkin Artem, Grigoriev Evgeny, Mikhailova Alena

机构信息

Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia.

出版信息

J Clin Med. 2024 Oct 11;13(20):6050. doi: 10.3390/jcm13206050.

Abstract

The components of donor blood themselves have the potential to initiate a systemic inflammatory response and exacerbate neuroinflammation, resulting in subsequent cerebral injury. The aim of this study was to establish the role of transfusion in the development of cerebral injury during the correction of congenital heart defects in children. A total of 78 patients aged from 1 to 78 months, with body weights ranging from 3.3 to 21.5 kg, were investigated. Biomarkers of cerebral injury and systemic inflammatory response were studied at three time points. First: prior to the surgical intervention. Second: after the completion of cardiopulmonary bypass. Third: 16 h after the conclusion of the surgery. The strongest correlation was found for S-100-β protein with the volume of transfusion at the second (Rho = 0.48, = 0.00065) and third time points (Rho = 0.36, = 0.01330). Neuron-specific enolase demonstrated a similar trend: Rho = 0.41 and = 0.00421 after the completion of cardiopulmonary bypass. The use of red blood cell suspension and its dosage per kilogram of body weight correlated with the biomarkers of cerebral injury and systemic inflammatory response with moderate to significant strength.

摘要

供血成分本身有可能引发全身炎症反应并加剧神经炎症,进而导致后续脑损伤。本研究的目的是确定输血在小儿先天性心脏病矫治过程中脑损伤发展中的作用。共对78例年龄在1至78个月、体重在3.3至21.5千克之间的患者进行了调查。在三个时间点研究了脑损伤和全身炎症反应的生物标志物。第一:手术干预前。第二:体外循环结束后。第三:手术结束后16小时。在第二个时间点(Rho = 0.48,P = 0.00065)和第三个时间点(Rho = 0.36,P = 0.01330)发现S-100-β蛋白与输血量的相关性最强。神经元特异性烯醇化酶也呈现类似趋势:体外循环结束后Rho = 0.41,P = 0.00421。红细胞悬液的使用及其每千克体重的剂量与脑损伤和全身炎症反应的生物标志物呈中度至显著强度的相关性。

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