Published online Apr 26, 2017. doi: 10.4330/wjc.v9.i4.332
Peer-review started: October 21, 2016
First decision: December 15, 2016
Revised: December 21, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: April 26, 2017
To demonstrate the feasibility of blood conservation methods and practice across all ages and risk categories in congenital cardiac surgery.
We retrospectively analyzed a collected database of 356 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) from 2010-2015. The patients were grouped into blood conservation (n = 138) and non-conservation (n = 218) groups and sub-grouped based on their ages and procedural complexity scores.
There were no statistical differences in gender, weight, pre-operative and pre-CPB hematocrit levels in both groups. Despite equivalent hematocrit levels during and after CPB for both groups, there was significantly less operative homologous blood utilized in blood conservation group across all ages and complexity levels.
Blood conservation surgery can be performed in congenital patients needing cardiac surgery in all age groups and complexity categories. The above findings in addition to attendant risks and side effects of blood transfusion and the rising cost of safer blood products justify blood conservation in congenital cardiac surgery.
Core tip: We evaluated the feasibility of blood conservation pediatric cardiac surgery for all age groups and complexity levels in this retrospective study. We reviewed 356 patients who underwent cardiac surgery from 2010-2015. The patients were grouped into historical non-conservation (NC = 218) and blood conservation (BC = 138) cohorts. The blood conservation was performed by miniaturizing bypass circuit, changing the trigger point for transfusion and adapting protocols and guidelines accepted and implemented by the group. We demonstrated that the blood conservation practice can be performed safely in all ages and complexity levels by reducing cardiopulmonary bypass prime volume and institutional commitment to guidelines and practice of blood conservation cardiac surgery.