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Impact of Blood Sampling Methods on Blood Loss and Transfusion After Pediatric Cardiac Surgery: An Observational
Mohammed Bin Joubah1, Ahmed Abdelaziz Ismail2, Gaser Abdelmohsen3
1Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Insights
The closed-loop sampling method significantly reduced blood loss in pediatric cardiac surgery patients. However, it did not decrease the need for blood transfusions, impacting postoperative care in the pediatric intensive care unit (PICU).
Area of Science:
- Pediatric Cardiac Surgery
- Intensive Care Medicine
- Hematology
Background:
- Pediatric cardiac surgery often involves significant blood loss and transfusion requirements.
- Optimizing postoperative management is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the effect of the closed-loop sampling method on blood loss and transfusion needs in pediatric patients post-cardiac surgery.
- To assess the impact on mechanical ventilation duration, ICU stay, hospital stay, and mortality.
Main Methods:
- Retrospective observational study at a single tertiary center.
- Included 143 pediatric patients (<4 years) undergoing cardiac surgery, divided into conservative (postimplementation) and nonconservative (preimplementation) groups.
- Primary outcome: blood loss volume; Secondary outcomes: blood transfusion requirements, ventilation duration, ICU/hospital stay, mortality.
Main Results:
- The closed-loop sampling method group showed a significant reduction in blood loss (0.67 mL/kg/d vs. 0.95 mL/kg/d, p=0.012).
- No significant differences were observed in blood transfusion volume or frequency between the groups.
- Duration of mechanical ventilation, ICU stay, hospital stay, and mortality were comparable.
Conclusions:
- The closed-loop sampling method effectively reduces postoperative blood loss in pediatric cardiac surgery patients.
- This method does not appear to decrease the frequency or volume of blood transfusions required.
- Further research may explore strategies to optimize transfusion management alongside blood loss reduction techniques.
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.
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