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

Resul Yılmaz; Beyza Koç; Alaaddin Yorulmaz; Fikret Akyürek

doi:10.16899/jcm.1408942

Clinical Research

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

Year 2024, Volume: 14 Issue: 3, 109 - 116

Resul Yılmaz Beyza Koç Alaaddin Yorulmaz Fikret Akyürek

https://doi.org/10.16899/jcm.1408942

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

References

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

Year 2024, Volume: 14 Issue: 3, 109 - 116

Resul Yılmaz Beyza Koç Alaaddin Yorulmaz Fikret Akyürek

https://doi.org/10.16899/jcm.1408942

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)

References

1. Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, et al. The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States. Crit Care Med 2004;32(1):39-52. DOI: 10.1097/01.Ccm.0000104112.34142.79.
2. Armano R, Gauvin F, Ducruet T, Lacroix J. Determinants of red blood cell transfusions in a pediatric critical care unit: a prospective, descriptive epidemiological study. Crit Care Med 2005;33(11):2637-44. DOI: 10.1097/01.ccm.0000185645.84802.73.
3. Bateman ST, Lacroix J, Boven K, Forbes P, Barton R, Thomas NJ, et al. Anemia, blood loss, and blood transfusions in North American children in the intensive care unit. Am J Respir Crit Care Med 2008;178(1):26-33. DOI: 10.1164/rccm.200711-1637OC.
4. Shorr AF, Corwin HL. Transfusion in critical care: where do we go from here? Chest 2007;132(4):1105-6. DOI: 10.1378/chest.07-1059.
5. Nagababu E, Rifkind JM. Reaction of hydrogen peroxide with ferrylhemoglobin: superoxide production and heme degradation. Biochemistry 2000;39(40):12503-11. DOI: 10.1021/bi992170y.
6. Shiva Shankar Reddy CS, Subramanyam MV, Vani R, Asha Devi S. In vitro models of oxidative stress in rat erythrocytes: effect of antioxidant supplements. Toxicol In Vitro 2007;21(8):1355-64. DOI: 10.1016/j.tiv.2007.06.010.
7. Motoyama T, Okamoto K, Kukita I, Hamaguchi M, Kinoshita Y, Ogawa H. Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome. Crit Care Med 2003;31(4):1048-52. DOI: 10.1097/01.Ccm.0000055371.27268.36.
8. Roth E, Manhart N, Wessner B. Assessing the antioxidative status in critically ill patients. Curr Opin Clin Nutr Metab Care 2004;7(2):161-8. DOI: 10.1097/00075197-200403000-00010.
9. Hadjinikolaou L, Alexiou C, Cohen AS, Standbridge Rde L, McColl AJ, Richmond W. Early changes in plasma antioxidant and lipid peroxidation levels following coronary artery bypass surgery: a complex response. Eur J Cardiothorac Surg 2003;23(6):969-75. DOI: 10.1016/s1010-7940(03)00115-5.
10. Valko M, Rhodes CJ, Moncol J, Izakovic M, Mazur M. Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chem Biol Interact 2006;160(1):1-40. DOI: 10.1016/j.cbi.2005.12.009.
11. Collard K, White D, Copplestone A. The influence of storage age on iron status, oxidative stress and antioxidant protection in paediatric packed cell units. Blood Transfus 2014;12(2):210-9. DOI: 10.2450/2013.0142-13.
12. Abdullah SM. The effect of repeated blood donations on the iron status of male Saudi blood donors. Blood Transfus 2011;9(2):167-71. DOI: 10.2450/2010.0040-10.
13. Dani C, Martelli E, Bertini G, Pezzati M, Rossetti M, Buonocore G, et al. Effect of blood transfusions on oxidative stress in preterm infants. Arch Dis Child Fetal Neonatal Ed 2004;89(5):F408-11. DOI: 10.1136/adc.2003.037085.
14. Klein HG, Anstee DJ. Mollison's blood transfusion in clinical medicine: John Wiley & Sons, 2014.
15. Sen CK, Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr 2000;72(2 Suppl):653s-69s. DOI: 10.1093/ajcn/72.2.653S.
16. Atmaca G. Antioxidant effects of sulfur-containing amino acids. Yonsei Med J 2004;45(5):776-88. DOI: 10.3349/ymj.2004.45.5.776.
17. Parcell S. Sulfur in human nutrition and applications in medicine. Altern Med Rev 2002;7(1):22-44.
18. Gurer H, Ercal N. Can antioxidants be beneficial in the treatment of lead poisoning? Free Radic Biol Med 2000;29(10):927-45. DOI: 10.1016/s0891-5849(00)00413-5.
19. Circu ML, Aw TY. Reactive oxygen species, cellular redox systems, and apoptosis. Free Radic Biol Med 2010;48(6):749-62. DOI: 10.1016/j.freeradbiomed.2009.12.022.
20. Matteucci E, Giampietro O. Thiol signalling network with an eye to diabetes. Molecules 2010;15(12):8890-903. DOI: 10.3390/molecules15128890.
21. Kundi H, Ates I, Kiziltunc E, Cetin M, Cicekcioglu H, Neselioglu S, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med 2015;33(11):1567-71. DOI: 10.1016/j.ajem.2015.06.016.
22. Ates I, Kaplan M, Yuksel M, Mese D, Alisik M, Erel O, et al. Determination of thiol/disulphide homeostasis in type 1 diabetes mellitus and the factors associated with thiol oxidation. Endocrine 2016;51(1):47-51. DOI: 10.1007/s12020-015-0784-6.
23. Yamaguchi J, Nagase M, Yamamoto Y, Sakurai A, Kubo A, Mitsuhashi H, et al. Increased oxidative stress and renal injury in patients with sepsis. J Clin Biochem Nutr 2018;63(2):137-143. DOI: 10.3164/jcbn.17-130.
24. Yilmaz R, Venkataraman S, Carcillo J, Kagan V, Bayir H. Antioxidant biomarkers in children with sepsis. CRITICAL CARE MEDICINE: LIPPINCOTT WILLIAMS & WILKINS 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA; 2009:A210-A210.
25. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014;47(18):326-32. DOI: 10.1016/j.clinbiochem.2014.09.026.
26. Gulbahar O, Adisen H, Koca C, Aricioglu A, Gulekon A. Changes in serum carbonyl and malondialdehyde levels following colchicine and vitamin E treatment in Behcet's disease. Methods Find Exp Clin Pharmacol 2007;29(8):521-4. DOI: 10.1358/mf.2007.29.8.1118136.
27. Demaret P, Tucci M, Ducruet T, Trottier H, Lacroix J. Red blood cell transfusion in critically ill children (CME). Transfusion 2014;54(2):365-375.
28. Bağcı M, Özcan PE, Şentürk E, Telci L, Çakar N. Kritik Hastalarda Anemi ve Kan Transfüzyonlarının Değerlendirilmesi. Journal of the Turkish Society of Intensive Care/Türk Yogun Bakim Dernegi Dergisi 2014;12(2):45-50.
29. Karam O, Tucci M, Bateman ST, Ducruet T, Spinella PC, Randolph AG, et al. Association between length of storage of red blood cell units and outcome of critically ill children: a prospective observational study. Critical Care 2010;14(2):1-8.
30. Lacroix J, Hébert PC, Hutchison JS, Hume HA, Tucci M, Ducruet T, et al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med 2007;356(16):1609-19. DOI: 10.1056/NEJMoa066240.
31. Carson JL, Grossman BJ, Kleinman S, Tinmouth AT, Marques MB, Fung MK, et al. Red blood cell transfusion: a clinical practice guideline from the AABB*. Ann Intern Med 2012;157(1):49-58. DOI: 10.7326/0003-4819-157-1-201206190-00429.
32. Carson JL, Guyatt G, Heddle NM, Grossman BJ, Cohn CS, Fung MK, et al. Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage. JAMA 2016;316(19):2025-2035. DOI: 10.1001/jama.2016.9185.
33. Doctor A, Cholette JM, Remy KE, Argent A, Carson JL, Valentine SL, et al. Recommendations on RBC Transfusion in General Critically Ill Children Based on Hemoglobin and/or Physiologic Thresholds From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr Crit Care Med 2018;19(9S Suppl 1):S98-s113. DOI: 10.1097/pcc.0000000000001590.
34. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001;345(19):1368-77. DOI: 10.1056/NEJMoa010307.
35. Hébert PC, Tinmouth A, Corwin HL. Controversies in RBC transfusion in the critically ill. Chest 2007;131(5):1583-90. DOI: 10.1378/chest.06-1055.
36. Akyildiz B, Ulgen Tekerek N, Pamukcu O, Dursun A, Karakukcu M, Narin N, et al. Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit. J Trop Pediatr 2018;64(2):118-125. DOI: 10.1093/tropej/fmx037.
37. Racek J, Herynková R, Holecek V, Faltysová J, Krejcová I. What is the source of free radicals causing hemolysis in stored blood? Physiol Res 2001;50(4):383-8.
38. Ho J, Sibbald WJ, Chin-Yee IH. Effects of storage on efficacy of red cell transfusion: when is it not safe? Crit Care Med 2003;31(12 Suppl):S687-97. DOI: 10.1097/01.Ccm.0000099349.17094.A3.
39. Wardle SP, Drury J, Garr R, Weindling AM. Effect of blood transfusion on lipid peroxidation in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002;86(1):F46-8. DOI: 10.1136/fn.86.1.f46.
40. Rosa SD, Bristot Mde L, Topanotti MF, Tomasi CD, Felisberto F, Vuolo FS, et al. Effect of red blood cell transfusion on parameters of inflammation and oxidative stress in critically ill patients. Rev Bras Ter Intensiva 2011;23(1):30-5.
41. Hirano K, Morinobu T, Kim H, Hiroi M, Ban R, Ogawa S, et al. Blood transfusion increases radical promoting non-transferrin bound iron in preterm infants. Archives of disease in childhood Fetal and neonatal edition 2001;84(3):F188-93. DOI: 10.1136/fn.84.3.f188.
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Details

Primary Language	English
Subjects	Pediatric Intensive Care
Journal Section	Original Research
Authors	Resul Yılmaz 0000-0001-7672-8100 Beyza Koç This is me 0000-0002-8187-9947 Alaaddin Yorulmaz 0000-0001-5478-1197 Fikret Akyürek 0000-0002-8091-7737
Early Pub Date	March 29, 2024
Publication Date
Submission Date	December 23, 2023
Acceptance Date	March 20, 2024
Published in Issue	Year 2024 Volume: 14 Issue: 3

Cite

AMA	Yılmaz R, Koç B, Yorulmaz A, Akyürek F. Effect of Erythrocyte Suspension Transfusion on Thiol-Disulfide Homeostasis in Critically Ill Children. J Contemp Med. March 2024;14(3):109-116. doi:10.16899/jcm.1408942

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