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 Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

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: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>