A multivariate analysis of factors affecting blood component requirement in pediatric open heart surgeries

Background

Bleeding in children after Cardiopulmonary Bypass (CPB) can be an important cause of morbidity and mortality. Multiple perioperative factors have been evaluated to predict bleeding and hence blood and blood component requirements in such children.

Materials and methods

Perioperative blood and blood product transfusion data were recorded for 264 children who underwent open heart procedures. Preoperative factors like patient age, sex, body surface area, hemoglobin, hematocrit, platelet count and cyanosis were compared with the Packed Red Cell (PRC), Fresh Frozen Plasma (FFP) and Random Donor Platelet (RDP) units transfused. Intraoperative factors like cardiopulmonary bypass time (CPB Time), prime type (heme prime done or not) and core body temperature attained during the surgery were also evaluated for the same. The results were statistically analyzed.

Results

Variables found to have a positive correlation with PRC use (i.e., those with p-value?<?0.05) are CPB time, heme prime and Partial Thromboplastin Time (PTT). However, age, hematocrit and cyanosis were negatively associated with PRC use. CPB time also had a positive correlation with Fresh Frozen Plasma and Random donor platelet usage. FFP use was positively correlated with heme prime performed. Cryoprecipitate consumption was positively correlated with preoperative cyanosis and hematocrit of the patient.

Conclusion

We identified patient??s age, preoperative hematocrit and coagulation profile, presence of cyanosis along with intraoperative parameters like prime type and CPB time as significant determinants of blood consumption especially packed red cells.