Open AccessCardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children
Author(s) -
А. А. Ивкин,
Д. В. Борисенко,
E. V. Grigoriev
Publication year - 2021
Publication title -
kompleksnye problemy serdečno-sosudistyh zabolevanij
Language(s) - English
Resource type - Journals
eISSN - 2587-9537
pISSN - 2306-1278
DOI - 10.17802/2306-1278-2021-10-2s-21-26
Subject(s) - medicine , cardiopulmonary bypass , enolase , anesthesia , brain damage , blood transfusion , glial fibrillary acidic protein , surgery , immunohistochemistry
Aim. To establish the role of donor blood components which are used in the intraoperative period in children with septal congenital heart disease (CHD) who need surgical interventions with cardiopulmonary bypass (CPB) for the prevention of cerebral injury in the postoperative period. Methods. 40 children of 14 months old on average and 8.8 kg of weight were under the study. All patients underwent radical correction of the septal CHD with the use of CPB. The patients were divided into 2 groups according to the donated blood components used. Cerebral damage was assessed with the help of three specific markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP). The severity of the systemic inflammatory response was defined by the level of the following markers: interleukin 1, 6 and 10 in serum before operations, after the completion of IC and 16 hours after surgery. The clinical analysis of cerebral injury was performed via the Cornell Assessment for Pediatric Delirium. Results. Statistically the concentration of all three markers of cerebral injury was significantly higher in the transfusion group after the end of CPB. Similar dynamics was observed in the concentrations of interleukins. In addition, the values for GFAP were higher in the transfusion group and 16 hours after surgery. Conclusion. The safety and effectiveness of the strategy on refusal of intraoperative transfusion in order to prevent cerebral injury in children during the correction of septal CHD has been demonstrated.