Transfusion-free cardiac surgery with cardiopulmonary bypass in a 2.2-kg neonate.
Particularly in neonates, complex cardiac surgery employing cardiopulmonary bypass normally requires the transfusion of autologous blood components. This is predominately caused by the relatively high priming volume of the circuit with subsequent extreme hemodilution. We report on a synoptic approach to avoiding transfusions in a 2.2 kg neonate with scheduled for correction of an intracardiac total anomalous pulmonary venous connection to the coronary sinus and a persistent foramen ovale. In this patient with a preoperative hemoglobin value of 16.5 g/dL, minimization of the cardiopulmonary bypass circuit, adjustment of the perfusion technique and strict reduction of blood sampling resulted in complete avoidance of transfusions during the entire course of the operation while maintaining safe hemoglobin levels, which never fell below a concentration of 8 g/mL.
Hübler
Michael
M
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Boettcher
Wolfgang
W
Koster
Andreas
A
Redlin
Matthias
M
Stiller
Brigitte
B
Lange
Peter
P
Hetzer
Roland
R
D001804:Blood Transfusion, Autologous / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002314:Cardioplegic Solutions; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight
D002314:Cardioplegic Solutions