tailieunhanh - Báo cáo y học: " Endothelial Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung: a case control study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Endothelial Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung: a case control study. | Tuinman et al. Critical Care 2011 15 R59 http content 15 1 R59 KS CRITICAL CARE RESEARCH Open Access Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung a case control study 1 1 4 12 3 Pieter R Tuinman Alexander P Vlaar Alexander D Cornet Jorrit J Hofstra Marcel Levi Joost CM Meijers Albertus Beishuizen4 Marcus J Schultz1 AB Johan Groeneveld4 Nicole P Juffermans1 Abstract Introduction Blood transfusion is associated with increased morbidity and mortality in cardiac surgery patients but cause-and-effect relations remain unknown. We hypothesized that blood transfusion is associated with changes in pulmonary and systemic inflammation and coagulation occurring in patients who do not meet the clinical diagnosis of transfusion-related acute lung injury TRALI . Methods We performed a case control study in a mixed medical-surgical intensive care unit of a university hospital in the Netherlands. Cardiac surgery patients n 45 were grouped as follows those who received no transfusion those who received a restrictive transfusion one two units of blood or those who received multiple transfusions at least five units of blood . Nondirected bronchoalveolar lavage fluid BALF and blood were obtained within 3 hours postoperatively. Normal distributed data were analyzed using analysis of variance and Dunnett s post hoc test. Nonparametric data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results Restrictive transfusion increased BALF levels of interleukin IL -1b and D-dimer compared to nontransfused controls P for all and IL-1P levels were further enhanced by multiple transfusions P . BALF levels of IL-8 tumor necrosis factor a TNFa and thrombin-antithrombin complex TATc were increased after multiple transfusions P P and P respectively compared to nontransfused controls but not after restrictive transfusions. Restrictive transfusions were associated with increased pulmonary .