Anemia after Pediatric Congenital Heart Surgery.
Camille JutrasKim Anh LaGeorge GerardisRachel RichardGeneviève Du Pont-ThibodeauPublished in: Journal of pediatric intensive care (2021)
The postoperative course of infants following congenital heart surgery is associated with significant blood loss and anemia. Optimal transfusion thresholds for cardiac surgery patients while in pediatric intensive care unit (PICU) remain a subject of debate. The goal of this study is to describe the epidemiology of anemia and the transfusion practices during the PICU stay of infants undergoing congenital heart surgery. A retrospective cohort study was performed in a PICU of a tertiary university-affiliated center. Infants undergoing surgery for congenital heart disease (CDH) before 6 weeks of age between February 2013 and June 2019 and who were subsequently admitted to the PICU were included. We identified 119 eligible patients. Mean age at surgery was 11 ± 7 days. Most common cardiac diagnoses were d-Transposition of the Great Arteries (55%), coarctation of the aorta (12.6%), and tetralogy of Fallot (11.8%). Mean hemoglobin level was 14.3 g/dL prior to surgery versus 12.1 g/dL at the PICU admission. Hemoglobin prior to surgery was systematically higher than hemoglobin at the PICU entry, except in infants with Hypoplastic Left Heart Syndrome. The average hemoglobin at PICU discharge was 11.7 ± 1.9 g/dL. Thirty-three (27.7%) patients were anemic at PICU discharge. Fifty-eight percent of patients received at least one red blood cell (RBC) transfusion during PICU stay. This study is the first to describe the epidemiology of anemia at PICU discharge in infants following cardiac surgery. Blood management of this distinctive and vulnerable population requires further investigation as anemia is a known risk factor for adverse neurodevelopment delays in otherwise healthy young children.
Keyphrases
- end stage renal disease
- chronic kidney disease
- minimally invasive
- cardiac surgery
- coronary artery bypass
- intensive care unit
- red blood cell
- ejection fraction
- newly diagnosed
- heart failure
- prognostic factors
- emergency department
- peritoneal dialysis
- healthcare
- acute kidney injury
- patients undergoing
- risk factors
- congenital heart disease
- patient reported outcomes
- surgical site infection
- left ventricular
- atrial fibrillation
- pulmonary arterial hypertension
- aortic valve
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- preterm birth
- patient reported
- gestational age