Red blood cell transfusion induces abnormal HIF-1 alpha response to cytokine storm after adult cardiac surgery
Kiviniemi Tuomas O.; Gunn Jarmo; Jalkanen Juho; Viikinkoski Emma; Vasankari Tuija; Lehto Joonas; Jalkanen Sirpa; Valtonen Mika; Biancari Fausto; Hollmén Maija; Airaksinen Juhani
Red blood cell transfusion induces abnormal HIF-1 alpha response to cytokine storm after adult cardiac surgery
Kiviniemi Tuomas O.
Gunn Jarmo
Jalkanen Juho
Viikinkoski Emma
Vasankari Tuija
Lehto Joonas
Jalkanen Sirpa
Valtonen Mika
Biancari Fausto
Hollmén Maija
Airaksinen Juhani
Nature Publishing Group
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2022012711072
https://urn.fi/URN:NBN:fi-fe2022012711072
Tiivistelmä
Patients undergoing cardiac surgery develop a marked postoperative systemic inflammatory response. Blood transfusion may contribute to disruption of homeostasis in these patients. We sought to evaluate the impact of blood transfusion on serum interleukin-6 (IL-6), hypoxia induced factor-1 alpha (HIF-1 alpha) levels as well as adverse outcomes in patients undergoing adult cardiac surgery. We prospectively enrolled 282 patients undergoing adult cardiac surgery. Serum IL-6 and HIF-1 alpha levels were measured preoperatively and on the first postoperative day. Packed red blood cells were transfused in 26.3% of patients (mean 2.93 +/- 3.05 units) by the time of postoperative sampling. Postoperative IL-6 levels increased over 30-fold and were similar in both groups (p = 0.115), whilst HIF-1 alpha levels (0.377 pg/mL vs. 0.784 pg/mL, p = 0.002) decreased significantly in patients who received red blood cell transfusion. Moreover, greater decrease in HIF-1 alpha levels predicted worse in-hospital and 3mo adverse outcome. Red blood cell transfusion was associated with higher risk of major adverse outcomes (stroke, pneumonia, all-cause mortality) during the index hospitalization. Red blood cell transfusion induces blunting of postoperative HIF-1 alpha response and is associated with higher risk of adverse thrombotic and pulmonary adverse events after cardiac surgery.
Kokoelmat
- Rinnakkaistallenteet [19207]