Impact of Blood Sampling Methods on Blood Loss and Transfusion After Pediatric Cardiac Surgery: An Observational Study

Abstract

Objective(s)The aim of this study was to assess the impact of the closed-loop sampling method on blood loss and the need for blood transfusion in pediatric patients following cardiac surgery. DesignRetrospective observational study. SettingA single tertiary center study. ParticipantsWe enrolled in this study all pediatric patients less than 4 years old who were admitted to PICU after cardiac surgery. The study involved 100 pediatric patients in the conservative (post-implementation) group, and 43 pediatric patients in the non-conservative group (pre-implementation) InterventionsObservational study. MeasurementsThe primary outcome of this study was the volume of blood loss during the PICU follow-up period. The secondary outcomes of this study were the requirement for blood transfusion in each group, duration of mechanical ventilation, ICU stay, hospital stay, and mortality. The main resultsIn the conservative (post-implementation) group, the blood loss during the follow-up period was 0.67 (0.33-1.16) ml/kg/day, while it was 0.95(0.50-2.30) ml/kg/day in the non-conservative (pre-implementation) group, demonstrating a significant reduction in blood loss in the conservative group, P value was 0.012. Both groups had no significant differences regarding the required blood transfusion volume postoperatively, during the first 24 hours, the first 48 hours, or after 48 hours (p-value was 0.061, 0.536, 0.442, respectively). The frequency of blood transfusion was comparable in both groups during the first 24 hours, the first 48 hours, or after 48 hours postoperatively (p-value was 0.277, 0.639, 0.075, respectively). In addition, both groups did not show significant differences in the duration of mechanical ventilation, ICU length of stay, hospital length of stay, and mortality ConclusionsThe closed-loop sampling method can be efficient to decrease the blood loss during postoperative PICU follow-up for pediatric patients after cardiac surgeries. However, its application didn't reduce the frequency or the volume of blood transfusion in those patients.