Usefulness of low prime perfusion pediatric circuit in decreasing blood transfusion.
We tested the efficiency of small prime volume in decreasing the blood requirement during pediatric cardiac surgery. This is a retrospective analysis of transfusion in 259 consecutive patients weighing <15 kg. We downsized the bypass circuit and avoided noncritical components to obtain a cardiopulmonary bypass prime volume, including a cardioplegia circuit of 140 ml for patients up to 6 kg, and of 170 ml for those weighing 6-15 kg. For intra- and postoperative care, transfusions were limited to 1 unit of packed red blood cells and 1 unit of fresh frozen plasma in 129 of the 134 patients weighing <6 kg. Seventy-six of 125 (61%) patients who were between 6 kg and 15 kg had bloodless surgery. None of the 259 patients had platelets infusion. In transfused cases, only eight patients (3%) needed more than two different donor products. In bloodless cases, hemoglobin values were 11.5 +/- 1.8 g/dl before, 9.4 +/- 1.7 g/dl during, and 10.5 +/- 1.8 g/dl after surgery. No adverse effects of this procedure were encountered. Small prime volume is efficient and safe in decreasing blood use in pediatric surgery.
Perfusion and Intensive Care Unit of Pediatric Cardiac Surgery, Institut Hospitalier Jacques Cartier, Avenue du Noyer Lambert, Massy, France.
Yves
Y
Durandy
D001835:Body Weight; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass / Q000379:methods* / Q000706:statistics & numerical data; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D004912:Erythrocytes / Q000737:chemistry / Q000378:metabolism; D006330:Heart Defects, Congenital / Q000097:blood / Q000628:therapy*; D006355:Heart-Lung Machine; D006801:Humans; D008904:Miniaturization; D010477:Perfusion / Q000379:methods; D011184:Postoperative Period; D011474:Prosthesis Design; D012189:Retrospective Studies; D016896:Treatment Outcome
D002314:Cardioplegic Solutions