Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rungatscher, A; Milani, E; Covajes, C; Hallström, S; Gottin, L; Guidi, GC; Luciani, GB; Faggian, G.
Blood transfusions may impair endothelium-dependent vasodilatation during coronary artery bypass surgery.
Microvasc Res. 2017; 112(1):109-114
Doi: 10.1016/j.mvr.2017.04.001
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Hallström Seth
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- Abstract:
- The hemolytic product free-hemoglobin (fHb) reduces nitric oxide (NO) bioavailability. The present study aims to establish whether administration of different blood transfusions result in increased circulating fHb levels and NO consumption with effects on arterial NO-dependent blood flow in patients undergoing CABG surgery. Ninety-five consecutive patients undergoing elective CABG surgery were prospectively divided in four groups based on blood transfusion requirements during surgery: stored blood cells (SBC, n. 21), intraoperative autologous salvaged blood (ASB, n. 25), SBC and ASB (n.22), no transfusion (control, n. 27). Blood samples were collected before and after intervention to analyse plasma levels of fHb and NO consumption. Endothelium-dependent relaxation was assessed in left internal mammary artery (LIMA) rings harvested before chest closure. Peripheral artery tonometry was assessed after intervention. Transfusions with SBC increased plasma fHb (p<0.05). Transfusions of ASB resulted in higher plasma fHb compared to SBC (p<0.01). fHb concentrations directly correlated with NO consumption (r=0.65, p<0.001). Maximal endothelium-dependent relaxation in LIMA was significantly attenuated in SBC and ASB patients compared to control (15.2±3.1% vs 21.1±2.5% vs 43±5.0% respectively; p<0.01). Significant correlations were identified between the aortic pressure wave velocity, plasma fHb concentration and NO consumption (p<0.01). Intraoperative blood transfusions and particularly autologous salvaged blood impair endothelium-dependent relaxation through NO scavenging by fHb. These findings obtained in vitro and in vivo provide new insights into the adverse relation between blood transfusions and patient outcome. Copyright © 2017 Elsevier Inc. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aged, 80 and over -
- Blood Transfusion -
- Blood Transfusion, Autologous - adverse effects
- Case-Control Studies -
- Coronary Artery Bypass - adverse effects
- Endothelium, Vascular - metabolism
- Endothelium, Vascular - physiopathology
- Female -
- Hemoglobins - metabolism
- Humans -
- Male -
- Mammary Arteries - physiopathology
- Mammary Arteries - surgery
- Middle Aged -
- Nitric Oxide - metabolism
- Operative Blood Salvage -
- Prospective Studies -
- Pulse Wave Analysis -
- Vascular Stiffness -
- Vasodilation -
- Find related publications in this database (Keywords)
- Blood transfusion
- Free hemoglobin
- Nitric oxide
- Endothelium-dependent vasodilatation
- Peripheral artery tonometry
- Coronary artery bypass grafting