Effects Of Red Blood Cell Storage On Patients Undergoing Cardiac Valve Replacement Under Cardiopulmonary Bypass

Objective:To evaluate the effects of blood cells storage on patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB).Providing a theoretical basis for clinically reasonable blood transfusion and red blood cell storage management.Methods:A total of 100 patients of both sexes,aged 55-70 year,BMI index 50-75 kg,scheduled for elective cardiac valve replacement under CPB,of ASA physical status ?or ?(NYHA ? or ?),were randomly divided into 2 groups using a random number table: The newer blood group(group NB,n = 47)and the Older blood group(group OB,n = 53).The NB group only received red blood cells stored for less than 2weeks.The OB group received red blood cells stored more than 2 weeks.Results:1.There was no significant difference in general conditions,left ventricular ejection fraction,duration of surgery,duration of extracorporeal circulation,duration of anesthesia,and number of red blood cell units transfused between the two groups(P>0.05).2.Compared with group OB,patients in group NB had a significantly decreased at renal and infectious complication and prolonged postoperative ventilation support(P<0.05).Postoperative length of stay in group OB was longer than group NB.There was no significant difference in the incidence of complications in the gastrointestinal tract,cardiovascular system,nervous system,and hemodynamics between the two groups(P> 0.05).The length of hospital stay in the NB group was 10.2± 1.3 days,compared with 13.5 ± 1.8 days in the OB group(p <0.05).Conclusion:1.Storage Red blood cells undergo a series of structural and functional changes during in vitro storage.The longer the storage time,the more severe the red blood cell damage.2.Patients undergoing heart valve replacement under CPB due to rheumatic heart disease have more poor prognosis after red blood cell infusion storage time than two weeks than red blood cell infusion storage time less than two weeks.3.The mechanism of unsatisfactory clinical outcome of patients undergoing heart valve replacement caused by infusion of red blood cells longer than two weeks remains unclear,and may be related to the inflammatory cascade caused by damaged red blood cells.