The objective of this study is to assess if prolonged storage time of a packed red blood cell unit may cause pulmonary vasoconstriction after transfusion, in a susceptible population such as cardiac surgery patients. The investigators will also evaluate the potential reversal effect of Inhaled Nitric Oxide on pulmonary vasoconstriction induced by stored blood transfusions.
Patients will be randomized into one of the three groups: I. Blood transfusion stored for less than 10 days II. Blood transfusion stored for more than 30 days III. Blood transfusion stored for more than 30 days days plus inhalation of Nitric Oxide at 80 part per million for an hour during blood transfusion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Nitric oxide at 80 part per million will be administrated by inhalation for approximately 1 hour during the blood transfusion
Massachusetts General Hospital
Boston, Massachusetts, United States
Pulmonary vascular resistance index
Parameters to calculate pulmonary vascular resistance index will be measured during and after blood transfusion for about 6 hours. The following parameters will be recorded: height, weight, systemic pressure, pulmonary pressure, wedge pressure, central venous pressure, cardiac output) of each subjects will be recorded.
Time frame: During and after blood transfusion- average time of observation 6 hours
Hemolysis
Hemolytic markers will be measured such as: haptoglobin, plasma free hemoglobin, hemopexin, and iron metabolites.
Time frame: During and after blood transfusion- average time of observation 6 hours
Nitric oxide metabolites
Plasma nitric oxide consumption, plasma and red blood cell levels of circulating nitrate, nitrite, nitric will be measured
Time frame: During and after blood transfusion- average time of observation 6 hours
Inflammation
Inflammation will be assessed by changes of the plasma concentration of cytokines, such as IL-6, IL-8, IL-10, IL-12, TNF, IFN-γ
Time frame: During and after blood transfusion- average time of observation 6 hours
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