Impact of Blood Sampling Methods on Blood Loss and Transfusion After Pediatric Cardiac Surgery: An Observational Study.

Autor: Joubah MB; Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Ismail AA; Department of Anesthesiology, Faculty of Medicine, Cairo University, Cairo, Egypt; Department of Cardiac Anesthesiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia., Abdelmohsen G; Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Cairo, Egypt., Alsofyani KA; Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Pediatric Critical Care Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia., Yousef AA; Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Jobah MT; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Khawaji A; Department of Pediatrics, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia., Abdelmawla M; Department of Pediatrics, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia., Sayed MH; Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia., Dohain AM; Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Cairo, Egypt; Department of Pediatrics, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Electronic address: adohain@yahoo.com.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2024 Sep; Vol. 38 (9), pp. 2002-2008. Date of Electronic Publication: 2024 Apr 05.
DOI: 10.1053/j.jvca.2024.04.005
Abstrakt: Objectives: The aims of this study were to assess the impact of the closed-loop sampling method on blood loss and the need for blood transfusion in pediatric patients following cardiac surgery.
Design: Retrospective observational study.
Setting: A single tertiary center.
Participants: All pediatric patients younger than 4 years old who were admitted to the pediatric intensive care unit (PICU) after cardiac surgery were enrolled. The study included 100 pediatric patients in the conservative (postimplementation) group and 43 pediatric patients in the nonconservative group (preimplementation).
Interventions: Observational.
Measurements: The primary outcome was the volume of blood loss during the PICU follow-up period. The secondary outcomes were the requirement for blood transfusion in each group, duration of mechanical ventilation, length of intensive care unit (ICU) stay, length of hospital stay, and mortality.
Main Results: In the conservative (postimplementation) group, blood loss during the follow-up period was 0.67 (0.33-1.16) mL/kg/d, while it was 0.95 (0.50-2.30) mL/kg/d in the nonconservative (preimplementation) group, demonstrating a significant reduction in blood loss in the conservative group (p = 0.012). The groups showed no significant differences in terms of the required blood transfusion volume postoperatively during the first 24 hours, first 48 hours, or after 48 hours (p = 0.061, 0.536, 0.442, respectively). The frequency of blood transfusion was comparable between the groups during the first 24 hours, first 48 hours, or after 48 hours postoperatively (p = 0.277, 0.639, 0.075, respectively). In addition, the groups did not show significant differences in the duration of mechanical ventilation, length of ICU stay, length of hospital stay, or mortality.
Conclusions: The closed-loop sampling method can be efficient in decreasing blood loss during postoperative PICU follow-up for pediatric patients after cardiac surgeries. However, its application did not reduce the frequency or the volume of blood transfusion in these patients.
Competing Interests: Declaration of competing interest All authors confirm that this study was self-funded. None of the authors have a financial interest or received honoraria or paid expert testimony. None of the authors have any personal relationships with people or organizations that could inappropriately influence (bias) this work.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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