Application of bloodless cardiopulmonary bypass strategy in infants

Zhao Hui; Yang Lei-yi; Lang Zhi-bin; Yao Dong-feng; Qian Xiao-liang; Ge Chang; Huang Jia-xin; Meng Fan-wei; Li Jing-hua; Cheng Zhao-yun

doi:10.13498/j.cnki.chin.j.ecc.2014.04.04

Abstract：[ Abstract]: Objective To discuss the feasibility of implementing comprehensive strategy of the extracorporeal circulation ( ECC) without blood transfusion and to evaluate the peri-operative safety of this strategy in low-weight infants. Methods Eighty in?fants diagnosed as congenital heart disease ( CHD) with 6~14 kg were divided into two groups since Nov. 2013 to May 2014. In the control group ( n=40) , all infants were applied with conventional ECC;All infants in the experimental group ( n=40) encounter the strategy of ECC without blood transfusion. Results All cases in the experimental group were succeed in the strategy of ECC without blood transfusion and 33 cases of them underwent the heart operation without blood transfusion in the whole perioperative period. All ca?ses recovered smoothly without serious complications occurred. Hemoglobin concentration in the experimental group was significantly lower than that of the control group ( P<0.05) , but still in the safe range. The concentration of lactic acid in experimental group was lower than that of control group ( P<0.05) at 20 minutes after ECC beginning. The mechanical ventilation time of the experimental group was significantly shorter than that of the control group ( P<0.05) . The drainage volume within 24 h after operation of the experi?mental group was less than that of the control group ( P<0.05) . There was no significant difference between the two groups as to the ICU stay time ( P>0.05) . Conclusion It is safe to implement the strategy of ECC without blood transfusion for the infants who have appropriate body weight and hemoglobin concentration. There is no undesirable influence on the infants during the perioperative period. The new strategy application in ECC can not only save blood but also reduce allogeneic blood transfusion. Most importantly, it is better for the recovery of the infants.