Approach to red blood cell transfusions in post-operative congenital heart disease surgery patients: when to stop?

• DOI: 10.1017/s1047951123003463
• Publication Date: 2023-10-06T08:23:31Z
• Authors: Murat Tanyildiz; Asiye Gungormus; Selin Ece Erden; Omer Ozden; Mehmet Bicer; Atif Akcevin; Ender Odemis
• Keywords: Heart Defects, Congenital; Transfusion; Cardiac and cardiovascular systems; Pediatrics; Pediatrics; 3. Good health; Hemoglobins; 0302 clinical medicine; Congenital heart surgery; Paediatric; Sepsis; Cardiac and cardiovascular systems; Humans; Transfusion; Congenital heart surgery; Paediatric; Cardiac intensive care unit; Cardiac intensive care unit; Child; Erythrocyte Transfusion; Retrospective Studies

Abstract Background: The best transfusion approach for CHD surgery is controversial. Studies suggest two strategies: liberal (haemoglobin ≤ 9.5 g/dL) and restrictive (waiting until haemoglobin 7.0 g/dL if the patient stable). Here we compare in post-operative patients a cardiac intensive care unit. Methods: Retrospective analysis was conducted on who received (2019–2021, n=53) (2021–2022, n=43). Results: groups were similar terms of age, gender, Paediatric Risk Mortality-3 score, Logistic Organ Dysfunction-2 Adjustment Congenital Heart Surgery-1 cardiopulmonary bypass time, vasoactive inotropic total fluid balance, mechanical ventilation duration, length unit stay, mortality. group had higher pre-operative level than (p < 0.05), with no differences anaemia. Regarding minimum maximum levels during both cases (p<0.01 p=0.019, respectively). number red blood cell transfusions by that 0.001). There between regarding lactate at time after transfusion. incidence bleeding, re-operation, acute kidney injury, dialysis, sepsis, systemic inflammatory response syndrome similar. Conclusions: Restrictive may be preferable over Achieving outcomes provide promising evidence future studies.