Packed Red Blood Cells Washed By Blood Recovery System And The Effect On The Concentration Of Inflammatory Mediators

Objective:To compare the differences including the concentration of inflammatory mediators, blood-gas analysis, biochemical and physiologic indexes between conventional packed red blood cells priming and packed red blood cells washed by blood recovery system during CPB and after operation in infants with congenital heart disease?CHD?underwent open heart surgery.Methods:The study was approved by theethics committee of Fujian Provincal Hospital, and all patients were voluntarily and signed informed consent. Forty infants whose weight between 5kg and 10 kg underwent the open heart surgery of ventricular septal defect repair in Fujian provincial hospital were divided into two groups infants according to the random number table, control group?n=20? received conventional packed red blood cells and experience group?n=20? received packed red blood cells washed by blood recovery system. The blood-gas analysis, electrolyte and physiologic indexes were measured pre-and-post-wash. The indexes above also were measured during and after bypass. Use theenzyme linked immune-sorbentassay method to determine the inflammatory mediators including Tumor Necrosis Factor-alpha?TNF-??and Interleukin-8?IL-8?of priming solution when 15 min after the start of CPB, the termination of CPB, 6 hours and 12 hours postoperatively. Compare the CPB process and the variety of hemodynamic parameters postoperatively, the chest drainage volume of total 48 hours after operation and the length of post-operation ventilation and ICU stay of two groups.Results:The CPB time, the aortic clamping time, the length of heart beat well recovery after aortic cross clamp release, hemodynamic parameters postoperatively, chest drainage volume of total 48 hours after operation of two groups had no statistic differences?P>0.05?.The length of postoperative ventilation were significantly shorter in experience group?P<0.05?. Compared to conventional packed red blood cells in control group,the figures of PH?PO₂?Hct?Hb?[Na⁺]?[Cl^-]?[Ca²⁺]and Osm increased significantly in washed packed red blood cells following PCO₂?[K⁺ ]?[HCO3^-]?Glu?Lac and Bun decreased significantly? P<0.05?, but No change in the concentration of [Mg²⁺]?P>0.05?.In control group, [K+ ] was significantly higher than experience group at CPB 3 minutes and CPB re-warming. The serum Glu concentration was significantly increased in the two groups after CPB 15 minutes?P< 0.05?. The serum Glu concentration was rather lower in experience group than control group after time of CPB re-warming?P< 0.05?. Experience group had significantly lower level of lactate at time of CPB 3 minutes?P< 0.05?. The serum [Ca²⁺] concentration was significantly higher at times of CPB end and after operation?P< 0.05?. The concentration of Hb and Hct in the two groups were significantly decreased?P < 0.05? at CPB 15 minutes. In the two groups,the figures of BE increased at CPB 3 minutes, and decreased at time of CPB re-warming then returned to the preoperative level?P < 0.05? at time of CPB end. Compared to conventional packed red blood cells and priming solution received conventional packed red blood cells in control group, TNF-a and IL-8 were lower?P<0.05? in blood cells washed in experience group.IL-8 were lower than those in control group at such times: CPB 15 min,CPB end, 6 hours and 12 hours postoperatively?P<0.05?. TNF-a at the termination of CPB and 6 hours postoperatively were lower than those in control group?P<0.05?, but they had no statistic differences between two groups at times of CPB 15 min and 12 hours after surgery?P>0.05?.Conclusions:The environment of packed red blood cells washed by blood recovery system is close to human body. They could reduce the inflammatory factors burden and activation of inflammatory response induced by cardiopulmonary bypass. So, this method may be beneficial to the recovery ofpulmonary function.