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Autologous blood donation for elective surgery in children weighing 8-25 kg
M N Mayer1, M de Montalembert, F Audat
1Département d'Anesthésie Réanimation, Chirurgicale, Hôpital Necker-Enfants Malades, Paris, France.
Insights
Autologous blood donation is safe for children weighing 8-25 kg. This pediatric blood collection method successfully avoided allogeneic transfusions in most cases, demonstrating its efficiency.
Area of Science:
- Pediatric Anesthesiology
- Transfusion Medicine
- Pediatric Surgery
Background:
- Autologous blood donation (ABD) is a common practice in adults.
- Its safety and efficacy in pediatric populations, especially for those with expected significant blood loss, require specific evaluation.
- Children weighing 8-25 kg undergoing major surgery are at risk for substantial perioperative blood loss.
Purpose of the Study:
- To assess the safety and efficiency of autologous blood donation in pediatric patients.
- To determine the feasibility of avoiding allogeneic blood transfusions through autologous blood collection in this cohort.
- To evaluate the tolerance and outcomes of autologous blood donation in children undergoing surgery.
Main Methods:
- Prospective study of 24 children (median age 6 years, weight 8-25 kg) with anticipated perioperative blood loss >25% of total blood volume.
- Blood collections performed in pediatric units under expert anesthesiologist and blood bank physician supervision.
- Included techniques such as intraoperative hemodilution and cell saver in addition to autologous blood donation.
Main Results:
- Forty of 46 prescribed blood collections were successfully performed; 6 were not due to maternal apprehension or venous access issues.
- All phlebotomies were hemodynamically well tolerated by the pediatric patients.
- Autologous blood donation successfully avoided the need for allogeneic blood transfusion in 21 out of 24 children.
Conclusions:
- Autologous blood donation can be safely and efficiently implemented in pediatric patients weighing 8-25 kg.
- This approach is effective in minimizing or eliminating the need for allogeneic blood transfusions in children undergoing surgery.
- Careful planning and experienced personnel are crucial for successful pediatric autologous blood donation programs.
Abstract:
To determine whether autologous blood donation can be used safely and efficiently in children weighing 8-25 kg, we studied children whose perioperative blood losses were expected to exceed 25% of total blood volume. Blood donations were performed in pediatric units, under the direction of an anesthesiologist and a blood bank physician experienced in paediatric care. Twenty-four children, median age 6 years (1-13), were included. They underwent surgery mainly for digestive or urological disorders, and for orthopedic defects. Forty blood collections were performed of the 46 prescribed. Phlebotomies could not be performed in 1 child because of the mother's apprehension, and in 5 cases because of venous access problems. All phlebotomies were hemodynamically well tolerated. Hemodilution was also performed in 17 children, and cell saver used in 2. Allogeneic blood transfusion was avoided in 21/24 children.