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.
Durandy
Yves
Y
Perfusion and Intensive Care Unit of Pediatric Cardiac Surgery, Institut Hospitalier Jacques Cartier, Avenue du Noyer Lambert, Massy, France.
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