Karimi M, Sullivan JM, Linthicum C, Mathew A. Blood conservation pediatric cardiac surgery in all ages and complexity levels. World J Cardiol 2017; 9(4): 332-338 [PMID: 28515851 DOI: 10.4330/wjc.v9.i4.332]
Corresponding Author of This Article
Mohsen Karimi, MD, Department of Surgery, Pediatric Cardiothoracic Surgery, Northeast Pediatric Specialties, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, 282 Washington Street, Suite 2B, Hartford, CT 06106, United States. mkarimi@connecticutchildrens.org
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2017; 9(4): 332-338 Published online Apr 26, 2017. doi: 10.4330/wjc.v9.i4.332
Blood conservation pediatric cardiac surgery in all ages and complexity levels
Mohsen Karimi, Jill M Sullivan, Carrie Linthicum, Anil Mathew
Mohsen Karimi, Jill M Sullivan, Department of Surgery, Pediatric Cardiothoracic Surgery, Northeast Pediatric Specialties, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, Hartford, CT 06106, United States
Carrie Linthicum, Department of Perfusion Services, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, Hartford, CT 06106, United States
Anil Mathew, Department of Pediatric Anesthesia, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, Hartford, CT 06106, United States
Author contributions: All the authors greatly contributed to this study.
Institutional review board statement: The institutional review board has exempted patients’ consent and approved the study.
Informed consent statement: No consent form needed due to retrospective nature of the study.
Conflict-of-interest statement: The author(s) received no financial support for the research and/or authorship of this article and there is no conflict of interest.
Data sharing statement: The original database is available by contacting corresponding author at mkarimi@connecticutchildrens.org.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mohsen Karimi, MD, Department of Surgery, Pediatric Cardiothoracic Surgery, Northeast Pediatric Specialties, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, 282 Washington Street, Suite 2B, Hartford, CT 06106, United States. mkarimi@connecticutchildrens.org
Telephone: +1-860-5458924 Fax: +1-860-5459410
Received: October 13, 2016 Peer-review started: October 21, 2016 First decision: December 15, 2016 Revised: December 21, 2016 Accepted: January 11, 2017 Article in press: January 14, 2017 Published online: April 26, 2017 Processing time: 196 Days and 10 Hours
Abstract
AIM
To demonstrate the feasibility of blood conservation methods and practice across all ages and risk categories in congenital cardiac surgery.
METHODS
We retrospectively analyzed a collected database of 356 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) from 2010-2015. The patients were grouped into blood conservation (n = 138) and non-conservation (n = 218) groups and sub-grouped based on their ages and procedural complexity scores.
RESULTS
There were no statistical differences in gender, weight, pre-operative and pre-CPB hematocrit levels in both groups. Despite equivalent hematocrit levels during and after CPB for both groups, there was significantly less operative homologous blood utilized in blood conservation group across all ages and complexity levels.
CONCLUSION
Blood conservation surgery can be performed in congenital patients needing cardiac surgery in all age groups and complexity categories. The above findings in addition to attendant risks and side effects of blood transfusion and the rising cost of safer blood products justify blood conservation in congenital cardiac surgery.
Core tip: We evaluated the feasibility of blood conservation pediatric cardiac surgery for all age groups and complexity levels in this retrospective study. We reviewed 356 patients who underwent cardiac surgery from 2010-2015. The patients were grouped into historical non-conservation (NC = 218) and blood conservation (BC = 138) cohorts. The blood conservation was performed by miniaturizing bypass circuit, changing the trigger point for transfusion and adapting protocols and guidelines accepted and implemented by the group. We demonstrated that the blood conservation practice can be performed safely in all ages and complexity levels by reducing cardiopulmonary bypass prime volume and institutional commitment to guidelines and practice of blood conservation cardiac surgery.
