| Reconstituted fresh whole blood improves clinical outcomes compared with stored component blood therapy for neonates undergoing cardiopulmonary bypass for cardiac surgery: a randomized controlled trial. | |
| | |
MedLine Citation:
|
PMID: 19114187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: This study compared the effects of reconstituted fresh whole blood against standard blood component therapy in neonates undergoing cardiac surgery. METHODS: Patients less than 1 month of age were randomized to receive either reconstituted fresh whole blood (n = 31) or standard blood component therapy (n = 33) to prime the bypass circuit and for transfusion during the 24 hours after cardiopulmonary bypass. Primary outcome was chest tube drainage; secondary outcomes included transfusion needs, inotrope score, ventilation time, and hospital length of stay. RESULTS: Patients who received reconstituted fresh whole blood had significantly less postoperative chest tube volume loss per kilogram of body weight (7.7 mL/kg vs 11.8 mL/kg; P = .03). Standard blood component therapy was associated with higher inotropic score (6.6 vs 3.3; P = .002), longer ventilation times (164 hours vs 119 hours; P = .04), as well as longer hospital stays (18 days vs 12 days; P = .006) than patients receiving reconstituted fresh whole blood. Of the different factors associated with the use of reconstituted fresh whole blood, lower platelet counts at 10 minutes and at the end of cardiopulmonary bypass, older age of cells used in the prime and throughout bypass, and exposures to higher number of allogeneic donors were found to be independent predictors of poor clinical outcomes. CONCLUSIONS: Reconstituted fresh whole blood used for the prime, throughout cardiopulmonary bypass, and for all transfusion requirements within the first 24 hours postoperatively results in reduced chest tube volume loss and improved clinical outcomes in neonatal patients undergoing cardiac surgery. |
| | |
Authors:
|
Colleen E Gruenwald; Brian W McCrindle; Lynn Crawford-Lean; Helen Holtby; Christopher Parshuram; Patricia Massicotte; Glen Van Arsdell |
Related Documents
:
|
11479507 - Retrograde cerebral perfusion provides negligible flow through brain capillaries in the... 17708157 - Changes in potassium concentration and haematocrit associated with cardiopulmonary bypa... 9068137 - Unaccounted blood loss in operations using cardiopulmonary bypass. 7994097 - Optimal perfusion pressure for experimental retrograde cerebral perfusion. 18228607 - Quantifying effects of particulate properties on powder flow properties using a ring sh... 12059007 - Biofeedback regulation of ultrafiltration and dialysate conductivity for the prevention... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 136 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2008 Dec |
Date Detail:
|
Created Date: 2008-12-30 Completed Date: 2009-01-29 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 1442-9 Citation Subset: AIM; IM |
Affiliation:
|
Labatt Family Heart Centre, Department of Perfusion, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. colleen.gruenwald@sickkids.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Component Transfusion
/
adverse effects Blood Transfusion / adverse effects*, methods* Cardiac Surgical Procedures* Cardiopulmonary Bypass Double-Blind Method Female Heart Defects, Congenital / surgery* Humans Infant, Newborn Male Prospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary blood supply of the inferior wall of the right ventricle in hearts with Ebstein malformatio...
Next Document: The myocardial protective effects of a moderate-potassium adenosine-lidocaine cardioplegia in pediat...