Effect of processing banked suspended red blood cells with cell saver before priming on perioperative systemic inflammatory responses of infants undergoing cardiac surgery under cardiopulmonary bypass

Abstract

Objective To evaluate the effects of processing banked suspended red blood cells (RBCs) with cell saver before priming on perioperative systemic inflammatory responses of infants undergoing cardiac surgery under cardiopulmonary bypass (CPB). Methods Forty pediatric patients of both sexes, aged 3 months-2 yr, weighing 5-13 kg, of American Society of Anesthesiologists physical status Ⅱ-Ⅳ, undergoing repair of atrial or ventricular septal defect under CPB, were divided into control group (group C, n=20) and processing group (group P, n=20) using a random number table.Banked suspended RBCs were primed directly after being added to CPB circuit in group C. Banked suspended RBCs were washed with cell saver and then primed after being added to CPB circuit in group P. At 5 min before skin incision, at 30 min after the start of CPB, at 10 min after aortic unclamping, immediately after the end of CPB and at 6, 12 and 24 h after the end of CPB (T1-7), blood samples were collected from the radial artery for determination of the concentrations of tumor necrosis factor, interleukin-1β (IL-1β), IL-6, IL-8, IL-10 and neutrophil elastase in plasma by enzyme-linked immunosorbent assay.Blood samples were taken from the radial artery at T1 and T4-7 for measurement of blood routine and plasma acute phase reactive protein concentrations. Results Compared with group C, the concentrations of tumor necrosis factor, IL-1β, IL-6, IL-8 and neutrophil elastase in plasma were significantly decreased at T6, 7, the total number of white blood cells, neutrophil count and concentration of plasma acute phase reactive protein were decreased at T7, and duration of stay in intensive care unit was shortened in group P (P<0.05). Conclusion Processing banked suspended RBCs with cell saver before priming can reduce perioperative systemic inflammatory responses of infants undergoing cardiac surgery under CPB. Key words: Erythrocytes; Cardiopulmonary bypass; Inflammation; Infant