S‐Nitrosohemoglobin Levels and Patient Outcome After Transfusion During Pediatric Bypass Surgery
Abstract
Banked blood exhibits impairments in nitric oxide (NO)‐based oxygen delivery capability, reflected in rapid depletion of S‐nitrosohemoglobin (SNO‐Hb). We hypothesized that transfusion of even freshly‐stored blood used in pediatric heart surgery would reduce SNO‐Hb levels and worsen outcome. In a retrospective review (n = 29), the percent of estimated blood volume (% eBV) replaced by transfusion directly correlated with ventilator time and inversely correlated with kidney function; similar results were obtained in a prospective arm (n = 20). In addition, an inverse association was identified between SNO‐Hb and postoperative increase in Hb (∆Hb), reflecting the amount of blood retained by the patient. Both SNO‐Hb and ∆Hb correlated with the probability of kidney dysfunction and oxygenation‐related complications. Further, regression analysis identified SNO‐Hb as an inverse predictor of outcome. The findings suggest that SNO‐Hb and ∆Hb are prognostic biomarkers following pediatric cardiopulmonary bypass, and that maintenance of red blood cell‐derived NO bioactivity might confer therapeutic benefit.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Dec 12, 2017
- Source ID
- 10.1111/cts.12530
Entities
People
- Anthony J. Cina
- Douglas T. Hess
- Faisal Matto
- Jacob Ostrowsky
- James D. Reynolds
- Jonathan S. Stamler
- Peter C. Kouretas
- Richard D. Smith
Organizations
- Case Western Reserve University
- Defense Advanced Research Projects Agency
- National Center for Advancing Translational Sciences
- National Institutes of Health
- UH Cleveland Medical Center