Author + information
- Meena Nathana,b,
- Brielle Tishlera,b,
- Kimberlee Gauvreaua,b,
- Gregory S. Mattea,b,
- Robert J. Howea,b,
- Linda Durhama,b,
- Sharon Boylea,b,
- Derek Mathieua,b,
- Francis Fynn-Thompsona,b,
- James Dinardoa,b and
- Juan Iblaa,b
Background: As part of a blood conservation initiative at our center, we began routine use of cell saver (CS) for all congenital heart surgery (CHS) performed on cardiopulmonary bypass (CPB) in 2014. The aim of this study is to compare transfusion rates prior to (preCS) and in the first (CS1) and second (CS2) year after this initiative.
Methods: Consecutive patients < 18 years undergoing CHS on CPB were included as 3 one year cohorts defined above. We excluded patients who required VAD/ECMO or second surgical operation on CPB at index admission. Baseline characteristics, use of blood intraoperatively and postoperatively, and postoperative albumin use were compared between groups using nonparametric methods.
Results: The three groups had similar baseline characteristics. Blood use was significantly higher in preCS group as compared to the other two groups both intra and postoperatively. The rate of albumin use decreased significantly with time. There was a trend towards decreased blood bank charges.
Conclusions: Cell saver implementation significantly decreased perioperative blood and albumin use. The ongoing improvement over time indicates the learning curve associated with any dramatic change in practice.
Clinical Implication: Reduction in blood and albumin use reduces development of reactive antibodies and other transfusion related complications. Future quality initiatives will be directed towards further reduction in blood and albumin use by development of transfusion threshold.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 1101-013
- 2017 American College of Cardiology Foundation