Bleeding problem among children with congenital heart disease in the postoperative period

Abstract

The aim – to study the frequency and volume of postoperative bleeding among children with operated congenital heart disease. Materials and Methods . Two groups of patients with cyanotic and nocyanotic congenital heart disease (CHD) were studied. Blood loss was assessed by volume and by the rate of exudation in the first two days of the postoperative period. For rapid diagnosis of coagulation parameters the level of prothrombin index and prothrombin time were determined. Results . It was found that the average volume and speed of blood loss in the first 12 hours of the postoperative period in children with cyanotic CHD had twice as much as patients with nocyanotic CHD and averaged (163.2±54.3) ml (17.4% of blood volume; p=0.05), and the average rate of bleeding – (1.12 ± 0.32) ml/kg per hour (p=0.002). Hypocoagulation observed changes of hemostasis in these patients, confirming the reduced level of prothrombin index ((75.3 ± 4.3)% , p = 0.002) and increased of prothrombin time ((21.7 ±2.2) s, p = 0.02) compared with patients of the second group. Conclusions . Analysis of the literature and the evidence suggests that children with cyanotic CHD make up a special group of cardiac patients. Because of the complexity of surgical treatment and longer extracorporeal circulation under conditions of hypothermia, in the postoperative period, in this group of patients, hemorrhagic complications a rise due hypocoagulation changes in the hemostatic system.