Usefulness of vacuum-assisted cardiopulmonary bypass circuit for pediatric open-heart surgery in reducing homologous blood transfusion.
OBJECTIVE
Open-heart surgery without homologous blood transfusion is still difficult in children because priming volume in cardiopulmonary bypass circuit results in extreme hemodilution. Vacuum-assisted cardiopulmonary bypass circuit has the benefit of improving venous return and results in lowering priming volume. We introduced vacuum-assisted cardiopulmonary bypass circuit in order to reduce priming volume for pediatric patients in March 1995. A retrospective study was made on the efficacy of vacuum-assisted circuit for pediatric open-heart surgery in reducing homologous blood transfusion.


METHODS
Patients weighing from 5 to 20 kg who underwent surgery between January 1991 and June 1996 were divided into two groups, group A comprised 128 patients before introduction of this circuit and group B comprised 49 patients after introduction, and their clinical course was compared. Vacuum-assisted circuit was used in 27 patients of group B.


RESULTS
The percentage of transfusion-free operations was significantly higher in group B than in group A (33.6% in group A vs. 53.1% in group B, P = 0.014), and particularly this percentage in patients weighing less than 10 kg significantly increased (0% in group A vs. 42.9% in group B, P < 0.01). The amount of homologous blood transfusion was significantly lower in group B than in group A (374 +/- 362 ml in group A and 212 +/- 287 ml in group B, P < 0.01). The rate of complications and the duration of respiratory support did not differ between the two groups. The duration of hospital stay was lower in group B than in group A.


CONCLUSIONS
The findings of this study indicate that vacuum-assisted circuit is useful for pediatric open-heart surgery in reducing homologous blood transfusion.
Nakanishi
K
K
Department of Cardiovascular Surgery, Hiroshima City Hospital, Hiroshima, Japan. koji_15@sannet.ne.jp
Shichijo
T
T
Shinkawa
Y
Y
Takeuchi
S
S
Nakai
M
M
Kato
G
G
Oba
O
O
D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014618:Vacuum