Original articleCongenital heart surgeryAssociation of Complications With Blood Transfusions in Pediatric Cardiac Surgery Patients
Section snippets
Study Design
The current study analyzed 1,631 CPB cases performed at the University of Michigan C.S. Mott Children’s Hospital Congenital Heart Center between January 1, 2008, and December 31, 2010. Institutional Review Board approval and waiver of consent were obtained to review the medical records of patients involved in the study. The institutional cardiac surgery database was used to obtain patient preoperative variables including age, weight, sex, prematurity (estimated gestational age <37 weeks),
Results
The mean PRBC transfusion for each age group was 175 ± 83 mL/kg, 100 ± 59 mL/kg, 40 ± 28 mL/kg, and 14 ± 20 mL/kg for groups 1, 2, 3, and 4, respectively. The median blood transfusion requirement was 161 mL/kg, 90 mL/kg, 55 mL/kg, and 6 mL/kg for age groups 1, 2, 3, and 4, respectively. The median platelet transfusion amount was 0.21 units/kg (range, 0 to 2.42 units/kg). The median cryoprecipitate and FFP transfusion value was 0; therefore, any patient receiving any quantity of these products
Comment
The current study demonstrates that intraoperative blood product transfusion is associated with significant risk of postoperative morbidity in the form of pulmonary complications and increased hospital length of stay in the pediatric cardiac surgery population. Conversely, mortality did not appear to correlate with increased intraoperative blood product transfusion.
The results of the current study are supported by other studies published in the literature. Salvin and colleagues [12] performed a
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2021, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Intraoperative RBC transfusions have been shown to be associated with greater postoperative blood loss, prolonged postoperative mechanical ventilation, infections, and longer stay in the intensive care unit after reparative infant cardiac surgery; however, these studies described heterogeneous cohorts with various cardiac malformations.27-30 In adult cardiac surgery, intraoperative RBC transfusion is associated with an increased incidence of postoperative pulmonary complications and prolonged length of hospitalization.31 Although anemic infants received significantly more often intraoperative, but not postoperative, RBC transfusions compared with the control group in the authors’ study, they did not show increased postoperative morbidities, duration of hospitalization, or mortality in anemic infants with d-TGA.
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