Blood Transfusion After Pediatric Cardiac Surgery Is Associated With Prolonged Hospital Stay

Blood Transfusions After Pediatric Cardiac Operations: A North American Multicenter Prospective Study

“…Costello and colleagues [3] demonstrated that postoperative exposure to three or more RBC transfusions was associated with an eightfold increase in the risk of organ space surgical site infection. A retrospective study of 802 children undergoing cardiac operations showed RBC transfusion was associated with prolonged hospital length of stay, with the strongest association found in children who had the highest exposure to RBC [5]. In a single-center Dutch study, transfusion of leukocytedepleted RBCs within the first 48 hours of PICU stay after a cardiac operation was independently associated with prolonged duration of mechanical ventilation [6].…”

“…In recent years, a growing body of evidence has suggested that postoperative RBC transfusion in this setting is associated with increased death, higher rates of infection, and a prolonged duration of postoperative mechanical ventilation [3][4][5][6]. What should drive practitioners to prescribe a RBC transfusion after a pediatric cardiac operation is not well determined.…”

Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass

“…[11] Although not in cardiac surgery patients similar observation of prolonged hospital stay was reported in a randomized, controlled trial examining "critically ill children" (n = 637) admitted to the pediatric ICU that examined restrictive and liberal transfusion strategies (thresholds of 7 g/dL and 9.5 g/dL, respectively). [12] Similarly, two other randomized studies in carried out in pediatric intensive care patients by Hébert et al and Lacroix et al reported the potential benefits of restricted transfusion elucidating the harmful effects of liberal transfusion.…”

Red Blood Cell Transfusion in the Postoperative Care of Pediatric Cardiac Surgery: Survey on Stated Practice

“…Though transfusion-related infectious complications of RBC transfusions have decreased in recent years [2], significant non-infectious serious hazards of transfusion remain, including storage lesions and transfusion-related immunomodulation [2][3][4]. RBC transfusion in pediatric cardiac surgery patients has been associated with longer ventilation time, prolonged hospital stay and increased infections [5][6][7]. Furthermore, RBC transfusion is associated with increased morbidity and mortality in adults with cardiac disease [8][9][10].…”