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

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

Artem Ivkin  1 , Evgeny Grigoriev  1 , Alena Mikhailova  1
Affiliations

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

Artem Ivkin et al. J Clin Med. .

Abstract

Background: 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. Material and Methods: 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. Results: The strongest correlation was found for S-100-β protein with the volume of transfusion at the second (Rho = 0.48, p = 0.00065) and third time points (Rho = 0.36, p = 0.01330). Neuron-specific enolase demonstrated a similar trend: Rho = 0.41 and p = 0.00421 after the completion of cardiopulmonary bypass. Conclusions: 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.

Keywords: cardiac surgery; children; neuroprotection; systemic inflammatory response; transfusion.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Diagram of the effects of pathological factors on the neurovascular unit during cardiac surgery.
Figure 2
Figure 2
Dynamics of S-100-β.
Figure 3
Figure 3
Dynamics of NSE.
Figure 4
Figure 4
Dynamics of GFAP.
Figure 5
Figure 5
Statistically significant correlations of the markers.
See this image and copyright information in PMC

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