title: Transfusion-free anesthetic management for open heart surgery in a neonate -A case report-.
abstract: In small infants or neonates, open heart surgery without transfusion can have many risks regarding inadequate oxygen delivery and coagulopathy. However, if parents refuse blood transfusion, cardiac surgery without transfusion should be considered. We report a case of bloodless cardiac surgery in a 2.89 kg neonate with Jehovah's Witness parents. Blood conserving strategies were used. Preoperatively, erythropoietin and iron were supplemented to increase the hemoglobin level. Intraoperatively, techniques for minimizing blood loss were used, such as reducing priming volume for cardiopulmonary bypass, a blood salvage system, and modified ultrafiltration. Postoperatively, pharmacologic agents were administered and blood sampling was minimized.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Byon
authors.forename: Jin-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Hee-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Chong Sung
authors.initials: CS
authors.lastname: Kim