Blood products for paediatric patients in congenital heart surgery

Abstract

ABSTRACT Introduction: Blood transfusions during paediatric cardiac surgery with cardiopulmonary bypass (CPB) carry increased risks, including infection and immunological complications. This study evaluates trends and factors influencing blood product use, particularly erythrocytes, following the implementation of a new blood management protocol from 2020 to 2023. Methods: A retrospective review of 135 paediatric patients who underwent congenital cardiac surgery with CPB was conducted. Patients were categorized into three age groups: Group 1 (< 1 year), Group 2 (1 – 4 years), and Group 3 (> 4 years). Data on erythrocyte, fresh frozen plasma (FFP), cryoprecipitate, and platelet use were analyzed using the Kruskal-Wallis and Spearman’s rho tests, with significance set at p < 0.05 and confidence interval (CI) of 95% quoted when applicable. Results: Erythrocyte use significantly declined over four years, with the largest reductions observed from 2020 to 2023 [p < 0.0001]. Older and heavier patients required fewer transfusions, with a significant inverse correlation between weight and erythrocyte use [Spearman’s rho = -0.29, p = 0.001]. Platelet use also decreased significantly from 2020 to 2023 [p = 0.04], while FFP and cryoprecipitate use declined notably over the same period [p < 0.01]. Conclusion: Over four years, significant reductions in blood product use were observed, particularly for erythrocytes and platelets. Patients age and weight were inversly related to erythrocyte transfusion needs. These trends may reflect improvements in surgical techniques and blood management protocols, with potential benefits for patient outcomes.