title: Effects of circuit residual volume salvage reinfusion on the postoperative clinical outcome for pediatric patients undergoing cardiac surgery.
abstract: This study aimed to evaluate the effects of washed cardiopulmonary (CPB) circuit residual blood reinfusion on the postoperative clinical outcome for pediatric patients undergoing cardiac surgery. A total of 309 consecutive Chinese cardiac patients receiving CPB between October 2010 and April 2011 were prospectively analyzed. For 217 patients, CPB circuit residual blood was reinfused after the cell-saving procedure [cell-salvage group (CS)]. The remaining 92 patients were directly transfused with allogenic red blood cells (RBCs) after their operation [control group (CON)]. Assessment included perioperative transfusion of RBCs, postoperative hematocrit (HCT), chest tube drainage during the first 24 h after the operation, intrahospital mortality, respiratory morbidity, and renal dysfunction. The two groups were well matched in terms of demographics, CPB data, and complexity of surgical procedure. The patients in the CS group had a significantly higher HCT level postoperatively (p = 0.018) and a less allogenic RBCs transfusion (p = 0.000). The two groups did not differ in terms of chest tube drainage during the first 24 h postoperatively, intrahospital mortality, or respiratory morbidity. The incidence of serum creatinine (≥ 2-folds) during the first 72 h after the operation was significantly lower in the CS group (2.3 %) than in the CON group (8.7 %) (p = 0.010). Reinfusion of washed CPB circuit residual blood significantly raised the postoperative HCT level, reduced the allogeneic blood transfusion, decreased the incidence of early postoperative renal dysfunction, and did not increase the chest tube drainage after the operation in pediatric cardiac surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Children's Hospital, School of Medicine, Zhejiang University, 57 Zhugan Lane, Hangzhou 310003, China.
authors.forename: Lifen
authors.initials: L
authors.lastname: Ye
authors.forename: Ru
authors.initials: R
authors.lastname: Lin
authors.forename: Yong
authors.initials: Y
authors.lastname: Fan
authors.forename: Lijun
authors.initials: L
authors.lastname: Yang
authors.forename: Jianling
authors.initials: J
authors.lastname: Hu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shu
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012115:Residual Volume; D016896:Treatment Outcome