Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Anemia is highly prevalent in the developing world and often it is aggravating in critically-ill children, which necessitates blood transfusion. Complications depend on different factors mostly filtration and storage of blood. The main cause of these complications can be explained by its effect on the innate immunity which can be represented by interleukin-6. Usage of fresh blood has a more beneficial effect than stored blood. Objectives:The aim of the study is to evaluate the role of interleukin-6 in determining the extent of innate immunity affection after packed RBCs transfusion in critically-ill children. Subjects and methods: This is a cross sectional study conducted on 30 patients before and after blood transfusion to determine interleukin-6 level in both occasions with the use of fresh and stored blood to detect the degree of immune affection with the use of each individually and monitoring the patients on day 2 and day 7 after transfusion for their clinical manifestations. Results:Packed RBCs transfusion causes immunosuppression which appeared here in the reduction of interleukin-6 although it was statistically non-significant (p{u02C3}0.05).Neurological system showed more dysfunction with the use of stored blood (p{u02C2}0.001), longer hospital stay was found in the stored blood group (p=0.041), more sepsis (p=0.001), more acute lung injury (p=0.028), acute respiratory distress syndrome (p=0.008), and death (p=0.001) all occurred with the stored blood group. Those who needed longer mechanical ventilation had a more reduction in IL6 r=0.442 (p=0.045) and further transfusions r=0.491 (p=0.006)confirming the suppression that had occurred in their innate immunity.Non-significant statistical difference had occurred with increasing the number of transfusions as regards the all measured parameters (p{u02C3}0.05) may be due to small sized samples

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