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Storage red blood cell (RBC) transfusion (prime) for extracorporeal circulation circuit in pediatric cardiac surgery: postoperative impact on biochemical changes

Atul Solanki, Ramesh Patel, Jigar Patel, Himanshu Acharya, Jignesh Patel, Dhaval Shukla.

Abstract
Background: In neonates, approximately 20% of red blood cell (RBC) and most of the plasma products are used for surgical procedures. The major reason for transfusion in cardiac surgery is because the extracorporeal circulation circuit (ECC) needs to be primed with blood. Biochemical changes take place when RBCs are kept for a phase of time and are together termed the storage lesion.

Objective: To clarify the incidence and nature of postoperative liver function, sepsis, and renal function associated with storage RBC prime for cardiopulmonary bypass circuit in new born, infants, and small children.

Materials and Methods: A total of 50 consecutive patients who underwent ECC between January 2014 and September 2015 and required blood prime were included in this study. Patients who required RBC were divided into two groups based on patients age and storage RBC age. Arterial blood sample and storage RBCs bag samples were collected in vivo for the assessment for postoperative biochemical parameters determinations.

Result: Postoperative white blood cell for >7-day storage RBCs prime in >365 days age patients is 16982.5 ± 4808.45. Postoperative serum glutamic pyruvic transaminase (SGPT) for >7-day storage RBCs prime in >365 days age patients mean (± SD) was 23.5 ± 7.56. Postoperative serum glutamic oxaloacetic transaminase (SGOT) for >7-day storage RBCs prime in >365 days age patients was 139.88 ± 70.32. Postoperative serum bilirubin for >7-day storage RBCs prime in >365 days age patients was 2.13 ± 0.99. Postoperative urea for >7-day storage RBCs prime in >365 days age patients was 25.88 ± 6.73. Postoperative serum creatinine for >7-day storage RBCs prime in >365 days age patients was 0 ± 0.

Conclusion: The age of storage RBCs and age of patient results in increased postoperative patients’ white blood counts, SGPT, SGOT, serum creatinine, and blood urea.

Key words: Storage RBCs, extracorporeal circuit, white blood counts, SGPT, SGOT, serum creatinine, blood urea



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