Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery

Abstract 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 a...

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Autores principales:	Emma Viikinkoski, Juho Jalkanen, Jarmo Gunn, Tuija Vasankari, Joonas Lehto, Mika Valtonen, Fausto Biancari, Sirpa Jalkanen, K. E. Juhani Airaksinen, Maija Hollmén, Tuomas O. Kiviniemi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/50a1170fb88c4eb9a6ce428389efc40c
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spelling	oai:doaj.org-article:50a1170fb88c4eb9a6ce428389efc40c2021-11-21T12:17:40ZRed blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery10.1038/s41598-021-01695-42045-2322https://doaj.org/article/50a1170fb88c4eb9a6ce428389efc40c2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01695-4https://doaj.org/toc/2045-2322Abstract 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. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT03444259.Emma ViikinkoskiJuho JalkanenJarmo GunnTuija VasankariJoonas LehtoMika ValtonenFausto BiancariSirpa JalkanenK. E. Juhani AiraksinenMaija HollménTuomas O. KiviniemiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Emma Viikinkoski Juho Jalkanen Jarmo Gunn Tuija Vasankari Joonas Lehto Mika Valtonen Fausto Biancari Sirpa Jalkanen K. E. Juhani Airaksinen Maija Hollmén Tuomas O. Kiviniemi Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
description	Abstract 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. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT03444259.
format	article
author	Emma Viikinkoski Juho Jalkanen Jarmo Gunn Tuija Vasankari Joonas Lehto Mika Valtonen Fausto Biancari Sirpa Jalkanen K. E. Juhani Airaksinen Maija Hollmén Tuomas O. Kiviniemi
author_facet	Emma Viikinkoski Juho Jalkanen Jarmo Gunn Tuija Vasankari Joonas Lehto Mika Valtonen Fausto Biancari Sirpa Jalkanen K. E. Juhani Airaksinen Maija Hollmén Tuomas O. Kiviniemi
author_sort	Emma Viikinkoski
title	Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
title_short	Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
title_full	Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
title_fullStr	Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
title_full_unstemmed	Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery
title_sort	red blood cell transfusion induces abnormal hif-1α response to cytokine storm after adult cardiac surgery
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/50a1170fb88c4eb9a6ce428389efc40c
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Red blood cell transfusion induces abnormal HIF-1α response to cytokine storm after adult cardiac surgery

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