Effect of Erythrocyte Suspension Transfusion on Thiol-Disulfide Homeostasis in Critically Ill Children

Abstract

Objective: To investigate the potential relation between dynamic thiol homeostasis and blood transfusion in the pediatric intensive care unit. Methods: Blood samples were collected from pediatric intensive care patients before and after erythrocyte suspension transfusion and from donor blood additionally to measure thiol levels. The study involved 30 patients, including nine females, and a total of 90 blood samples from patients and donors were analyzed. Results: Prior to transfusion, Total Thiol (TT) and Native Thiol (NT) were 414.77 ± 156.14 (μmol/L) and 272.63 ± 115.75 (μmol/L), respectively, and post-transfusion, they were found to decrease to 398.07 ± 187.38 (μmol/L) and 258.97 ± 136.2 (μmol/L), respectively. However, no statistically significant difference was observed between pre- and post-transfusion values. In post-transfusion blood samples, there was a significant increase in Disulfide/TT and Disulfide/NT ratios, indicating an increase in oxidation (34.79 ± 92.34 and 51.89 ± 68.51, respectively), yet no statistical difference was noted. Conclusion: Transfusions administered in the Pediatric Intensive Care Unit were associated with a decrease in total and native thiol levels, indicative of increased oxidative stress, despite the lack of statistically significant differences. To mitigate the potential negative impact on patients with high oxidative properties after transfusions, strengthening the antioxidant defense system is recommended. Research should be planned to develop suitable strategies for enhancing the antioxidant defense system and ensuring patients' resilience to this condition.

Keywords

• children
• erythrocyte suspension transfusion
• pediatric intensive care
• dynamic thiol homeostasis

Ethical Statement

The study was carried out with the permission of Selçuk University Non-interventional Clinical Researches Ethics Committee (Date: 13/01/2021, Decision No: 2021/01)

Eritrosit Süspansiyonu Transfüzyonunun Kritik Hasta Çocuklarda Tiyol-Disülfid Homeostazı Üzerindeki Etkisi

Abstract

Amaç: Çocuk yoğun bakım ünitesinde kan transfüzyonu ile dinamik thiol homeostasisi arasında bir bağlantı olup olmadığını araştırmak. Yöntemler: Çocuk yoğun bakım ünitesinde yatan hastalarda kan transfüzyonundan önce ve sonra ek olarak donör kanından thiol düzeylerini ölçmek için kan örnekleri alındı. Dokuzu kız toplam 30 hastanın ve ek olarak donörlerin 90 kan örneğinde araştırma yapıldı. Bulgular: Transfüzyondan önceki Total tiyol (TT) ve Nativ tiyol (NT) sırasıyla 414,77 ± 156,14 (μmol/L) ve 272,63 ± 115,75 (μmol/L) idi, transfüzyon sonrasında ise yine sırasılya 398,07 ± 187,38(μmol/L) ve 258,97 ± 136,2(μmol/L) transfüzyon öncesine göre azalmış olarak bulundu. Ancak, transfüzyon öncesi ve sonrası arasında istatistiksel olarak anlamlı bir fark gösterilemedi. Transfüzyondan sonraki kan örneklerinde ise oksidasyonun artışına delalet eden Disülfid/TT ve Disülfid/NT oranlarında önemli bir artış oldu, (sırasıyla 34,79±92,34 ve 51,89±68,51) yine, istatistiksel olarak bir fark gösterilemedi. Sonuç: Çocuk Yoğun Bakım ünitesinde uygulanan kan transfüzyonları, istatistiksel olarak anlamlı fark olmasa da artmış oksidatif stresi gösteren total ve nativ tiyolde azalma ve disülfid oranlarında artış ile ilişkilendirildi. Oksidatif özelliği fazla olan ES ile transfüzyon sonrası hastaların bu durumdan olumsuz etkilenmemesi için antioksidan savunma sisteminin güçlendirilmesi düşünülmeli ve uygun stratejilerin geliştirilmesi için araştırmalar planlanmalıdır.

Keywords

• çocuk
• eritrosit süspansiyonu transfüzyonu
• pediatrik yoğun bakım
• dinamik tiyol homeostazisi

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