Blood Conservation in Pediatric Cardiac Surgery

Abstract

There are many blood conservation strategies available for children undergoing cardiac surgery. These strategies will vary depending on patient age and type of surgery

Blood conservation strategies in cardiac surgery

“…PAD, pre‐bypass ANH, minimizing the priming of the CPB circuit, intra‐ and postoperative cell salvage, and the use of pharmacological agents in addition to careful surgical haemostasis have all been associated with a significant reduction in allogeneic blood use. Many of these blood‐conservation techniques are available for children, although their use will depend on patient age and type of surgery [86]. However, the true impact of the different techniques on allogeneic blood requirements and their clinical benefits remain to be determined.…”

Blood Conservation Strategies in Cardiac Surgery

“…Blood conservation includes a variety of methods intended to decrease hemodilution, reduce blood loss and improve hemostasis. Pouard 16 reviews the different techniques, focusing on specificities related to pediatric patients. Available devices and techniques do not allow for safe, bloodless CPB for complex repairs in very young and lowweight children.…”

Retrograde Autologous Priming Technique to Reduce Hemodilution during Cardiopulmonary Bypass in the Pediatric Cardiac Patient

“…Blood transfusions are associated with several complications, including acute lung injury, anaphylactic reaction, immunologic sensitization, organ dysfunction, and disease transmission (1,4). In pediatric cardiac surgery, bank blood in the priming solution has been a source of bradykinin and interleukins, resulting in inflammatory reactions that can lead to postoperative complications such as longer intubation times and intensive care length of stay (5). Substantial progress has been made in reducing the need for blood products during pediatric cardiac surgery by implementing techniques such as modified ultrafiltration (MUF) and universal cell saver (6)(7)(8).…”