Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Reconstituted blood is better for infants’ heart surgery than fresh blood

14.10.2004


Using reconstituted blood – packed red cells and fresh-frozen plasma that are mixed in the operating room just before use – for heart bypass surgery in infants works better than using fresh whole blood, researchers at UT Southwestern Medical Center at Dallas and Children’s Medical Center Dallas have found.



Babies who received the reconstituted blood during surgery to repair congenital heart defects on average had shorter stays in the intensive care unit and spent less time on mechanical ventilation after surgery than babies who received fresh whole blood – blood that is less than 48 hours old and whose red cells and plasma have not been separated.

The findings, which appear in today’s New England Journal of Medicine, put to rest a decades-long debate in the medical community, said Dr. Daniel Stromberg, assistant professor of pediatrics at UT Southwestern and the study’s senior author. "The results demonstrate that the current national opinion regarding the benefits of fresh whole blood is incorrect," said Dr. Stromberg, who is also a cardiologist at Children’s. "Fresh whole blood priming of the cardiopulmonary bypass circuit is actually worse in terms of clinical outcomes. This is important for patients and for blood banks – potentially saving lots of money and preserving component inventory."


During heart surgery, babies must be placed on a cardiopulmonary bypass machine, which does the work of the heart and lungs while surgeons make repairs. The machine must be primed with donor blood because babies do not have enough of their own blood to supply both the machine and their tiny bodies. Blood priming of the cardiopulmonary bypass machine is not necessary for adults, whose blood volume is larger.

Traditionally, surgeons have insisted on using fresh whole blood to prime the bypass machine and would even cancel procedures when it wasn’t available. Using reconstituted blood would ease blood centers’ burden of meeting the demand for whole blood, researchers said. Physicians estimate that 19,000 operations for congenital heart disease are performed annually in the United States, with the majority requiring cardiopulmonary bypass.

One benefit of using fresh whole blood in the cardiopulmonary bypass machine was that the patient’s donor exposure was decreased: one donor as compared to two donors with the reconstituted blood. That risk could be easily minimized by using both components of reconstituted blood from the same donor, Dr. Stromberg said.

Reconstituted blood also costs slightly more initially than fresh blood. but the overall savings from reconstituted blood use during recovery could be thousands of dollars. During the study, babies who received the reconstituted blood for heart surgery left the cardiac ICU roughly 25 percent quicker than those getting fresh blood (70.5 hours to 97 hours) and spent 31 percent less time on mechanical ventilation following surgery (36.3 hours to 53 hours). The reconstituted blood group also demonstrated less accumulation of fluid 48 hours after surgery (-6.9 milliliter per kilogram of body weight to 28.8 ml/per kg).

Researchers studied 200 patients during a four-year period at Children’s; participants were younger than 1 year old with congenital heart defects that required open heart surgery to repair. Patients were randomly assigned to receive fresh whole blood or reconstituted blood during surgery. All blood products used were acquired from a standard donor pool and underwent routine screening for infectious agents, as required by the Food and Drug Administration. All care providers, except for the operating room perfusionist and circulating nurse – who monitor and operate equipment that oxygenates the blood during open heart surgery, were blinded to the patient’s group assignment.

Other UT Southwestern researchers who participated in the study were Dr. Steven Mou, a fellow in the pediatric intensive care unit; Dr. Brett Giroir, professor of pediatrics; Dr. Erica Molitor-Kirsch, assistant professor of pediatrics; Dr. Steven R. Leonard, professor of cardiovascular and thoracic surgery; Dr. Hisashi Nikaidoh, professor of cardiovascular and thoracic surgery; and Dr. William Scott, professor of pediatrics. Deborah Town, a nurse and clinical research coordinator at Children’s; Dr. Lonnie Roy, biostatistician and senior planning analyst in Children’s market research department; and Dr. Frank Nizzi of Carter BloodCare in Dallas were also involved in the study.

Staishy Bostick Siem | EurekAlert!
Further information:
http://www.utsouthwestern.edu

More articles from Health and Medicine:

nachricht Cystic fibrosis alters the structure of mucus in airways
28.06.2017 | University of Iowa Health Care

nachricht Mice provide insight into genetics of autism spectrum disorders
28.06.2017 | University of California - Davis

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

High conductive foils enabling large area lighting

29.06.2017 | Power and Electrical Engineering

Designed proteins to treat muscular dystrophy

29.06.2017 | Life Sciences

Climate Fluctuations & Non-equilibrium Statistical Mechanics: An Interdisciplinary Dialog

29.06.2017 | Seminars Workshops

VideoLinks
B2B-VideoLinks
More VideoLinks >>>