Blood Transfusion and Inflammation in Cardiac Surgery
Author Information
Author(s): Tuinman PR, Vlaar AP, Cornet AD, Hofstra JJ, Levi M, Meijers JC, Beishuizen A, Schultz MJ, Groeneveld JB, Juffermans NP
Primary Institution: Academic Medical Center, Amsterdam, the Netherlands
Hypothesis
Blood transfusion is associated with changes in pulmonary and systemic inflammation and coagulopathy in cardiac surgery patients.
Conclusion
Transfusion during cardiac surgery activates inflammation and coagulation in the lungs, which may contribute to acute lung injury.
Supporting Evidence
- Restrictive transfusion increased BALF levels of IL-1β compared with nontransfused controls.
- Multiple transfusion further enhanced BALF levels of IL-1β.
- BALF levels of IL-8, TNFα, and TATc were increased after multiple transfusion compared with nontransfused controls.
- Restrictive transfusion was associated with increased pulmonary levels of plasminogen activator inhibitor-1.
- Transfusion was associated with a significant increase in levels of TNFα, TATc, and PAA.
Takeaway
Giving blood transfusions during heart surgery can make the lungs and blood clotting system react badly, even if the patient doesn't show obvious signs of lung injury.
Methodology
A case-control study was conducted with cardiac surgery patients grouped by transfusion status, and bronchoalveolar lavage fluid and blood were analyzed postoperatively.
Participant Demographics
Cardiac surgery patients from a university hospital.
Statistical Information
P-Value
P < 0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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