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. 2014 Feb 11:9:32.
doi: 10.1186/1749-8090-9-32.

Factors affecting postoperative blood loss in children undergoing cardiac surgery

David Faraoni  1 , Philippe Van der Linden
Affiliations

Factors affecting postoperative blood loss in children undergoing cardiac surgery

David Faraoni et al. J Cardiothorac Surg. .

Abstract

We hypothesized that the influence of cyanotic disease on postoperative blood loss is closely related to age in children undergoing cardiac surgery. Here, we demonstrate that the presence of a cyanotic disease is associated with increased postoperative blood loss in children aged 1 to 6 months. Children with cyanotic disease and aged<1 month who received fresh frozen plasma during cardiopulmonary bypass had less postoperative blood loss and higher maximal clot firmness on FIBTEM than cyanotic children from all other groups. Additional studies are needed to define optimal pathophysiology-based management in children undergoing cardiac surgery.

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Figures

Figure 1
Figure 1
Blood loss based on age and the presence of cyanotic disease. *p < 0.005 comparing < 1 month and 1-6 months with cyanotic disease (mean difference between groups 7.9% estimated blood volume (EBV), 95% CI 1.4 to 14); ** p < 0.05 comparing 1-6 months and 6-12 months with cyanotic disease (mean difference between groups -6.1% EBV, 95% CI -12 to -0.15); *** p < 0.05 comparing 1-6 months and 1-3 years with cyanotic disease (mean difference between groups -5.6% EBV, 95% CI -11 to -0.12); **** p < 0.005 comparing 1-6 months and > 3 years with cyanotic disease (mean difference between groups -6.9% EBV, 95% CI -13 to -1.3).
Figure 2
Figure 2
Coagulation parameters based on age and the presence of cyanotic disease. (A) Fibrinogen levels measured using the Clauss method at baseline and after cardiopulmonary bypass (CPB) (p < 0.001). (B) Platelet count at baseline and after CPB (p < 0.001). (C) Maximal clot firmness obtained on FIBTEM after CPB. (D) Maximal clot firmness obtained on EXTEM after CPB. ***p < 0.001 comparing < 1 month and all other groups with cyanotic and non-cyanotic diseases, #p < 0.01 comparing < 1 month and all other groups with cyanotic diseases. Blue, cyanotic patients; red, non-cyanotic patients; clear symbols represent baseline tests; and full symbols represent post-CPB tests.
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