This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A. Articles by Grigoryants, R. G. Search for Related Content PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Grigoryants, R. G. Related Collections Related Article

eComment: Re: The impact of allogenic red cell transfusion and coated bypass circuit on the inflammatory response during cardiopulmonary bypass: a randomized study

Bakoulev Scientific Center for Cardiovascular Surgery, Roublevskoye Sh 135, 121552 Moscow, Russia

The impact of allogenic red cell transfusion and coated bypass circuit on the inflammatory response during cardiopulmonary bypass: a randomized study

The influence of red cell transfusion on the inflammatory response during cardiopulmonary bypass (CPB) is a very important factor as it is shown in the published article [1]. The increase of inflammatory response during CPB leads to postoperative complications and is a risk factor for mortality and morbidity in cardiac surgery [2], [3]. Another important factor, according to the data of the authors, is the continuous research of different circuit systems coated with heparin or of polymer systems providing less inflammation and better preservation of serum proteins during CPB. Many studies published in recent years have shown that the first problem can be solved with the help of the blood conservation programme that includes predictors of bleeding, autodonation, erythropoietin and iron therapy administration in the preoperative period. Besides that, the essential role is given to the choice of low level of hematocrit during CPB as well as the usage of cell salvage in the operative period, which leads to the reduction of transfusion [4].

The second problem is far from being solved. The most common synthetic coating used in bypass circuits is heparin. Several commercial products are GT. available in the US and in Europe, but they have appeared to be unreasonable for blood conservation in cardiac operation. Poly-2-methoxyethylacrylate (PMEA) is an amphiphilic polymer with a polyethylene chain that is a coated bypass circuit, which must decrease inflammation and absorption of the protein during CPB. As with the heparin coating the results of its usage are contradictory and do not allow to make meta-analyses. The usage of the coated bypass circuit made from PMEA is supposed to continue further in order to reach a single opinion. The future decision of this problem is firstly in the technological development of the biocompatibility of the synthetic materials.

The authors of the article have studied very important aspects for cardiac surgery. This study is very accurate, methodically proved and genuine. This research deserves a big practical and scientific interest.

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1. Senay S, Toraman F, Gunaydin S, Kilercik M, Karabulut H, Alhan C. The impact of allogenic red cell transfusion and coated bypass circuit on the inflammatory response during cardiopulmonary bypass: a randomized study. Interact CardioVasc Thorac Surg 2009;8:93–99.[Abstract/Free Full Text]
2. Murphy GJ, Reeves BC, Rogers CA, Rizvi SI, Culliford L, Angelini GD. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation 2007;116:2544–2552.[Abstract/Free Full Text]
3. Scott BH, Seifert FC, Grimson R. Blood transfusion is associated with increased resource utilization, morbidity and mortality in cardiac surgery. Ann Card Anaesth 2008;11:15–19.[Medline]
4. Ferraris VA, Ferraris SP, Saha SP, Hessel EA, Haan CK, Royston BD, Bridges CR, Higgins RS, Despotis G, Brown JR, Spiess BD, Shore-Lesserson L, Staford-Smith M, Mazer DC, Bennett-Guerrero E, Hill SE, Body S. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologist clinical practice guideline. Ann Thorac Surg 2007;83:S27–S86.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A. Articles by Grigoryants, R. G. Search for Related Content PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Grigoryants, R. G. Related Collections Related Article