title: Post-operative blood loss following cardio-pulmonary bypass in children.
abstract: Significant post-operative bleeding may occur following cardio-pulmonary bypass, sometimes necessitating early re-exploration. Two questions were asked by this study. Firstly, in children undergoing cardio-pulmonary bypass, can pre-operative, operative and immediately post-operative variables be used to predict post-operative blood loss? Secondly, in the same patient group, can the same variables be used to predict the surgical intervention of re-exploration for excessive bleeding within 12 h of surgery? In a prospective study of patients operated on in a 9-month period, bleeding fell rapidly in the first 3 h after surgery and early re-exploration for bleeding was necessary in 8 of the 206 patients. The only significant predictor of post-operative blood loss was minimum oesophageal temperature, low values being associated with greater blood loss (correlation r = -0.19 (P < 0.05)). With regard to re-exploration for bleeding, a long bypass time (P < 0.05) and abnormal pre-operative coagulation indices (P < 0.01) were significant and independent predictors. The data were also used to create a practical nomogram relating re-exploration for bleeding to hourly post-operative blood loss.
authors.affiliation: Department of Cardiac Surgery, Children's Hospital, Ladywood Middleway, Birmingham, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Evans
authors.forename: R L
authors.initials: RL
authors.lastname: Holder
authors.forename: W J
authors.initials: WJ
authors.lastname: Brawn
authors.forename: B
authors.initials: B
authors.lastname: Sethia
mesh_terms: D001831:Body Temperature; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D004947:Esophagus / Q000502:physiology; D006330:Heart Defects, Congenital / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007223:Infant; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation