Strategies for blood conservation in pediatric cardiac surgery

Cardiac surgery accounts for the majority of blood transfusions in a hospital. Blood transfusion has been associated with complications and major adverse events after cardiac surgery. Compared to adults it is more difficult to avoid blood transfusion in children after cardiac surgery. This article takes into account the challenges and emphasizes on the various strategies that could be implemented, to conserve blood during pediatric cardiac surgery.

[1]  Y. Ujike,et al.  A prospective randomized trial comparing the clinical effectiveness and biocompatibility of heparin-coated circuits and PMEA-coated circuits in pediatric cardiopulmonary bypass , 2016, Perfusion.

[2]  Ying Sun,et al.  Epsilon aminocaproic acid reduces blood transfusion and improves the coagulation test after pediatric open-heart surgery: a meta-analysis of 5 clinical trials. , 2015, International journal of clinical and experimental pathology.

[3]  M. Genoni,et al.  Viscoelastic blood coagulation measurement with Sonoclot predicts postoperative bleeding in cardiac surgery after heparin reversal. , 2015, Journal of cardiothoracic and vascular anesthesia.

[4]  S. Takanashi,et al.  Biocompatibility of cardiopulmonary bypass circuit with new polymer Senko E-Ternal CoatingTM , 2015, Perfusion.

[5]  D. Bichell,et al.  Association of Blood Products Administration During Cardiopulmonary Bypass and Excessive Post-operative Bleeding in Pediatric Cardiac Surgery , 2015, Pediatric Cardiology.

[6]  Elizabeth C. Wilson,et al.  Excessive Postoperative Bleeding and Outcomes in Neonates Undergoing Cardiopulmonary Bypass , 2015, Anesthesia and analgesia.

[7]  S. Bratton,et al.  Reducing Blood Testing in Pediatric Patients After Heart Surgery: A Quality Improvement Project* , 2014, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[8]  S. Langley,et al.  Congenital cardiac lesions involving systolic flow abnormalities are associated with platelet dysfunction in children. , 2014, The Annals of thoracic surgery.

[9]  Mei-yan Feng,et al.  Closed blood conservation device for reducing catheter-related infections in children after cardiac surgery. , 2014, Critical care nurse.

[10]  D. Macrae,et al.  Comparison between thromboelastography and conventional coagulation tests after cardiopulmonary bypass surgery in the paediatric intensive care unit , 2014, International journal of laboratory hematology.

[11]  K. Muralidhar.  Modified Blalock Taussig shunt: comparison between neonates, infants and older children. , 2014, Annals of cardiac anaesthesia.

[12]  K. Harrington,et al.  Anemia and red blood cell transfusion in critically ill cardiac patients , 2014, Annals of Intensive Care.

[13]  C. Mélot,et al.  The indication for perioperative red blood cell transfusions is a predictive risk factor for severe postoperative morbidity and mortality in children undergoing cardiac surgery. , 2014, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[14]  P. Simpson,et al.  Increased recombinant activated factor VII use and need for surgical reexploration following a switch from aprotinin to epsilon-aminocaproic acid in infant cardiac surgery. , 2014, Journal of clinical anesthesia.

[15]  Hironori Matsuhisa,et al.  Intraoperative tranexamic acid in pediatric bloodless cardiac surgery , 2014, Asian cardiovascular & thoracic annals.

[16]  S. Chauhan,et al.  Recombinant activated factor VII in cardiac surgery: single-center experience , 2014, Asian cardiovascular & thoracic annals.

[17]  Y. Durandy,et al.  Warm blood microplegia redosing interval in pediatric surgery. , 2013, The Annals of thoracic surgery.

[18]  J. Lightdale,et al.  Economic evaluation of cell salvage in pediatric surgery , 2013, Paediatric anaesthesia.

[19]  P. Gruber,et al.  Current cardioplegia practice in pediatric cardiac surgery: a North American multiinstitutional survey. , 2013, The Annals of thoracic surgery.

[20]  R. Wolterbeek,et al.  Safety and effects of two red blood cell transfusion strategies in pediatric cardiac surgery patients: a randomized controlled trial , 2013, Intensive Care Medicine.

[21]  J. Rousou,et al.  Use of Fibrin Sealants in Cardiovascular Surgery: A Systematic Review , 2013, Journal of cardiac surgery.

[22]  J. Gornbein,et al.  Increased Red Blood Cell Transfusions Are Associated with Worsening Outcomes in Pediatric Heart Transplant Patients , 2013, Anesthesia and analgesia.

[23]  R. Lakshmy,et al.  Comparison of different doses of ε-aminocaproic acid in children for tetralogy of Fallot surgery: clinical efficacy and safety. , 2013, Journal of cardiothoracic and vascular anesthesia.

[24]  Michael F Swartz,et al.  Transfusion of Cell Saver Salvaged Blood in Neonates and Infants Undergoing Open Heart Surgery Significantly Reduces RBC and Coagulant Product Transfusions and Donor Exposures: Results of a Prospective, Randomized, Clinical Trial* , 2013, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[25]  S. Chauhan,et al.  Sonoclot analysis in children with congenital heart disease , 2012, Asian cardiovascular & thoracic annals.

[26]  P. Simpson,et al.  Thromboelastography in the Assessment of Bleeding Following Surgery for Congenital Heart Disease , 2012, World journal for pediatric & congenital heart surgery.

[27]  A. Pérez-Ferrer,et al.  Cardiac surgery without blood products in a Jehovah's Witness child with factor VII deficiency. , 2012, Journal of cardiothoracic and vascular anesthesia.

[28]  N. Magon,et al.  Recombinant Factor VIIa in Post-partum Hemorrhage: A New Weapon in Obstetrician's Armamentarium , 2012, North American journal of medical sciences.

[29]  S. Chauhan,et al.  Recombinant activated factor VII for hemorrhage after pediatric cardiac surgery , 2012, Asian cardiovascular & thoracic annals.

[30]  D. Faraoni.  Safety of tranexamic acid in pediatric cardiac surgery: what we do not know. , 2011, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[31]  T. Katogi,et al.  Modified versus conventional ultrafiltration in pediatric cardiac surgery: a meta-analysis of randomized controlled trials comparing clinical outcome parameters. , 2011, The Journal of thoracic and cardiovascular surgery.

[32]  G. Kenet,et al.  Point of care testing in children undergoing cardiopulmonary bypass , 2011, Pediatric blood & cancer.

[33]  Mohamed A. Fouda,et al.  Mini-cardiopulmonary bypass impact on blood conservation strategy in coronary artery bypass grafting. , 2011, Interactive Cardiovascular and Thoracic Surgery.

[34]  N. B. Lerner,et al.  Children with single-ventricle physiology do not benefit from higher hemoglobin levels post cavopulmonary connection: Results of a prospective, randomized, controlled trial of a restrictive versus liberal red-cell transfusion strategy* , 2011, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[35]  H. Vohra,et al.  Mini extracorporeal circuit cardiopulmonary bypass system: a review , 2010, Perfusion.

[36]  D. Wensley,et al.  Comparison of two red-cell transfusion strategies after pediatric cardiac surgery: A subgroup analysis , 2010, Critical care medicine.

[37]  P. Cameron,et al.  Recombinant Activated Factor VII in Obstetric Hemorrhage: Experiences from the Australian and New Zealand Haemostasis Registry , 2009, Anesthesia and analgesia.

[38]  R. Millner,et al.  A review of topical hemostatic agents for use in cardiac surgery. , 2009, The Annals of thoracic surgery.

[39]  G Despotis,et al.  Prediction and management of bleeding in cardiac surgery , 2009, Journal of thrombosis and haemostasis : JTH.

[40]  Y. Durandy.  The Impact of Vacuum-Assisted Venous Drainage and Miniaturized Bypass Circuits on Blood Transfusion in Pediatric Cardiac Surgery , 2009, ASAIO journal.

[41]  I. Fukuda,et al.  Poly-2-methoxyethylacrylate-coated bypass circuits reduce activation of coagulation system and inflammatory response in congenital cardiac surgery , 2008, Journal of Artificial Organs.

[42]  R. Martineau,et al.  A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. , 2008, The New England journal of medicine.

[43]  W. White,et al.  The effect of aprotinin on outcome after coronary-artery bypass grafting. , 2008, The New England journal of medicine.

[44]  John D Seeger,et al.  Aprotinin during coronary-artery bypass grafting and risk of death. , 2008, The New England journal of medicine.

[45]  F. Pigula,et al.  The effect of hematocrit during hypothermic cardiopulmonary bypass in infant heart surgery: results from the combined Boston hematocrit trials. , 2008, The Journal of thoracic and cardiovascular surgery.

[46]  D. Holt,et al.  Can vacuum assisted venous drainage be achieved using a roller pump in an emergency? A pilot study using neonatal circuitry. , 2007, The journal of extra-corporeal technology.

[47]  Shunji Sano,et al.  Impact of Miniaturization of Cardiopulmonary Bypass Circuit on Blood Transfusion Requirement in Neonatal Open-Heart Surgery , 2007, ASAIO journal.

[48]  K. Kavaklı,et al.  Frequency of acquired von Willebrand’s disease in children with congenital heart disease , 2007, Acta cardiologica.

[49]  J. Lowe,et al.  Evaluation of the topical hemostatic efficacy and safety of TISSEEL VH S/D fibrin sealant compared with currently licensed TISSEEL VH in patients undergoing cardiac surgery: a phase 3, randomized, double-blind clinical study. , 2007, The Journal of cardiovascular surgery.

[50]  J. Takeda,et al.  Impact of Sonoclot hemostasis analysis after cardiopulmonary bypass on postoperative hemorrhage in cardiac surgery , 2007, Journal of Anesthesia.

[51]  Sibu P Saha,et al.  Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. , 2007, The Annals of thoracic surgery.

[52]  M. Martínez-Ferro,et al.  Thoracoscopic double aortic arch division with Harmonic scalpel: a case report. , 2007, The Journal of thoracic and cardiovascular surgery.

[53]  Masahiro Yoshida,et al.  The efficacy of preoperative administration of a single dose of recombinant human erythropoietin in pediatric cardiac surgery. , 2007, The heart surgery forum.

[54]  L. Aarts,et al.  Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation , 2006, Transfusion medicine.

[55]  P. Kirshbom,et al.  Failure of surface-modified bypass circuits to improve platelet function during pediatric cardiac surgery. , 2006, The Journal of thoracic and cardiovascular surgery.

[56]  J. Hammel,et al.  Evaluation of biocompatible cardiopulmonary bypass circuit use during pediatric open heart surgery. , 2006, The journal of extra-corporeal technology.

[57]  D. Cook,et al.  Avoiding Transfusions in Children Undergoing Cardiac Surgery: A Meta-Analysis of Randomized Trials of Aprotinin , 2006, Anesthesia and analgesia.

[58]  I. C. Tudor,et al.  The risk associated with aprotinin in cardiac surgery. , 2006, The New England journal of medicine.

[59]  P. Pouard.  Blood Conservation in Pediatric Cardiac Surgery , 2005 .

[60]  A. Anselmi,et al.  Harmonic scalpel reduces bleeding and postoperative complications in redo cardiac surgery. , 2005, The Annals of thoracic surgery.

[61]  J. van der Linden,et al.  Aprotinin reduces bleeding and blood product use in patients treated with clopidogrel before coronary artery bypass grafting. , 2005, The Annals of thoracic surgery.

[62]  J. van der Linden,et al.  Aprotinin Decreases Postoperative Bleeding and Number of Transfusions in Patients on Clopidogrel Undergoing Coronary Artery Bypass Graft Surgery: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial , 2005, Circulation.

[63]  F. Trojette,et al.  Clinical experience with the mini-extracorporeal circulation system: an evolution or a revolution? , 2004, The Annals of thoracic surgery.

[64]  S. Chauhan,et al.  Comparison of epsilon aminocaproic acid and tranexamic acid in pediatric cardiac surgery. , 2004, Journal of cardiothoracic and vascular anesthesia.

[65]  J. Hanks,et al.  A Comparison of the Haemostatic Effect of Vivostat® Patient-Derived Fibrin Sealant with Oxidised Cellulose (Surgicel®) in Multiple Surgical Procedures , 2003, European Surgical Research.

[66]  D. Stump,et al.  Does vacuum-assisted venous drainage increase gaseous microemboli during cardiopulmonary bypass? , 2002, The Annals of thoracic surgery.

[67]  M. Codispoti,et al.  Significant merits of a fibrin sealant in the presence of coagulopathy following paediatric cardiac surgery: randomised controlled trial. , 2002, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[68]  S. Chauhan,et al.  Efficacy of aprotinin, epsilon aminocaproic acid, or combination in cyanotic heart disease. , 2000, The Annals of thoracic surgery.

[69]  R. Corradi,et al.  Trillium™ Biopassive Surface: A New Biocompatible Treatment for Extracorporeal Circulation Circuits , 2000, The International journal of artificial organs.

[70]  Jeffrey A. White,et al.  Heparin‐Coated Cardiopulmonary Bypass Circuit: Clinical Effects in Pediatric Cardiac Surgery , 2000, Journal of cardiac surgery.

[71]  Y. Takanashi,et al.  Clinical efficacy of heparin-bonded bypass circuits related to cytokine responses in children. , 2000, The Annals of thoracic surgery.

[72]  S. Chauhan,et al.  Epsilon aminocaproic acid in paediatric cardiac surgery to reduce postoperative blood loss. , 2000, The Indian journal of medical research.

[73]  R. Hopkins,et al.  Veno-arterial modified ultrafiltration in children after cardiopulmonary bypass. , 1999, The journal of extra-corporeal technology.

[74]  M. Turrentine,et al.  Dilutional and modified ultrafiltration reduces pulmonary hypertension after operations for congenital heart disease: a prospective randomized study. , 1998, The Journal of thoracic and cardiovascular surgery.

[75]  R. Friesen,et al.  Modified ultrafiltration attenuates dilutional coagulopathy in pediatric open heart operations. , 1997, The Annals of thoracic surgery.

[76]  P. Menasché.  Blood cardioplegia: do we still need to dilute? , 1996, The Annals of thoracic surgery.

[77]  J. Davis,et al.  Transfusion patterns in pediatric open heart surgery , 1996, Transfusion.

[78]  S. Inaba,et al.  Preoperative autologous blood donations in pediatric cardiac surgery. , 1995, The Annals of thoracic surgery.

[79]  M. Turina,et al.  Prevention of residual ventricular septal defects with fibrin sealant. , 1995, The Annals of thoracic surgery.

[80]  A. Mezzetti,et al.  Intermittent antegrade warm blood cardioplegia. , 1995, The Annals of thoracic surgery.

[81]  G. Hempelmann,et al.  Aprotinin in pediatric cardiac operations: platelet function, blood loss, and use of homologous blood. , 1993, The Annals of thoracic surgery.

[82]  P. Hickey,et al.  Coagulation defects in neonates during cardiopulmonary bypass. , 1993, The Annals of thoracic surgery.

[83]  G. S. Hughes,et al.  A double stopcock technique for repeated sampling of venous blood. , 1992, Methods and findings in experimental and clinical pharmacology.

[84]  D. Cosgrove,et al.  Randomized clinical trial of fibrin sealant in patients undergoing resternotomy or reoperation after cardiac operations. A multicenter study. , 1989, The Journal of thoracic and cardiovascular surgery.

[85]  W. Seybold-epting,et al.  Local Hemostasis with Fibrin Glue after Intracardiac Repair of Tetralogy of Fallot and Transposition of the Great Arteries , 1983, The Thoracic and cardiovascular surgeon.

[86]  Y. Durandy.  Use of blood products in pediatric cardiac surgery. , 2015, Artificial organs.

[87]  S. Langley,et al.  Preoperative platelet dysfunction predicts blood product transfusion in children undergoing cardiac surgery. , 2015, Interactive cardiovascular and thoracic surgery.

[88]  Jinkwon Lee,et al.  Multiple Approaches to Minimize Transfusions for Pediatric Patients in Open-Heart Surgery , 2015, Pediatric Cardiology.

[89]  J. Tobias,et al.  Cerebral Oximetry Monitoring During Preoperative Phlebotomy to Limit Allogeneic Blood Use in Patients Undergoing Cardiac Surgery , 2012, Pediatric Cardiology.

[90]  J. Tobias,et al.  Decreasing the Need for Transfusion: Infant Cardiac Surgery Using Hemodilution and Recombinant Factor VIIa , 2012, Pediatric Cardiology.

[91]  F. Pigula,et al.  Blood transfusion after pediatric cardiac surgery is associated with prolonged hospital stay. , 2011, The Annals of thoracic surgery.

[92]  J. Thomson,et al.  Heart surgery in infants with hemophilia. , 2006, The Annals of thoracic surgery.

[93]  K. Fujiwara,et al.  Preliminary Study of Autologous Blood Predonation in Pediatric Open-Heart Surgery , 2003, Pediatric Cardiology.

[94]  Y. Xin.  Comparison of the effects of epsilon-aminocaproic acid and aprotinin on fibrinolytic system in children undergoing cardiopulmonary bypass , 2003 .

[95]  M. Yamaguchi,et al.  Effects of Modified Ultrafiltration on Coagulation Factors in Pediatric Cardiac Surgery , 2002, Surgery Today.

[96]  M. Kalmanti,et al.  Erythropoietin (rHuEPO) administration to premature infants for the treatment of their anemia. , 1998, Pediatric hematology and oncology.

[97]  P. Vouhé,et al.  Surgical treatment of multiple ventricular septal defects using a biologic glue. , 1994, The Journal of thoracic and cardiovascular surgery.

[98]  P. Menasché,et al.  Simplified method for delivering normothermic blood cardioplegia. , 1993, Annals of Thoracic Surgery.

[99]  S. Nicolson,et al.  Comparison of the hemostatic effects of fresh whole blood, stored whole blood, and components after open heart surgery in children. , 1991, Blood.

[100]  L. W. Mason.  Obstetric hemorrhage. , 1948, Rocky Mountain medical journal.