Viikinkoski, E., Jalkanen, J., Gunn, J. et al. Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery. Sci Rep 11, 22230 (2021). https://doi.org/10.1038/s41598-021-01695-4
Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
|Author:||Viikinkoski, Emma1; Jalkanen, Juho2; Gunn, Jarmo1;|
1Heart Center, Turku University Hospital and University of Turku, Hämeenkatu 11, 20521 Turku, Finland
2MediCity Research Laboratory, Department of Microbiology and Immunology, University of Turku, Tykistönkatu 6A, 20520 Turku, Finland
3Intensive Care Unit, Turku University Hospital and University of Turku, Hämeenkatu 11, 20521 Turku, Finland
4Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
5Research Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, University of Oulu, Oulu, Finland
6Brigham and Women’s Hospital, Harvard Medical School, 60 Fenwood Rd, BTM 7012, Boston, MA 02115, USA
7Heart Center, Turku University Hospital and University of Turku, POB 52, 20521Turku, Finland
|Online Access:||PDF Full Text (PDF, 1.2 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2022020717924
|Publish Date:|| 2022-02-08
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-1α) 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-1α 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-1α 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-1α 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 α response and is associated with higher risk of adverse thrombotic and pulmonary adverse events after cardiac surgery.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
Finnish Medical Foundation, the Finnish Foundation for Cardiovascular Research, Helsinki, Finland; State Clinical Research Fund (EVO) of Turku University Hospital, Turku, Finland. The funding was provided by Turun Yliopistollisen Keskussairaalan Koulutus- ja Tutkimussäätiö, Turun Yliopisto, Orionin Tutkimussäätiö, Sydäntutkimussäätiö, Emil Aaltosen Säätiö, Suomen Kulttuurirahasto, Suomen Lääketieteen Säätiö, Suomen Kardiologinen Seura and also by Kuistilan Muistosäätiö.
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