Intensive Care Unit and Perfusion Department,Pediatric Cardiac Surgery, Institut HospitalierJacques Cartier, Massy, France.
Artif Organs. 2010 Nov;34(11):1057-61. doi: 10.1111/j.1525-1594.2010.01158.x.
The aim of the study is to measure the volume of homologous blood needed for one pediatric patient during his hospital stay. Over a 4-month period, all the patients operated upon with a blood prime or requiring blood transfusion during their hospital stay were included in this study.The cardiopulmonary bypass protocol associates a miniaturized bypass circuit, vacuum-assisted venous drainage, and microplegia. The volume of each blood product opened is known and the volume of blood product remaining, following the last transfusion, is measured. Data collected areas follows: patient weight; hemoglobin level before surgery,during bypass, and in intensive care after the last transfusion;time to extubation; and degree of inotropic support.Forty-six patients weighing 5.1 1.5 kg were included in this study. Cardiopulmonary bypass priming volume was 100 mL for patients up to 3.5 kg, 120 mL for patients between 3.6 and 7.5 kg, and 160 mL for patients between 7.6 and 8.6 kg. The volume of blood transfusion was 271 112 mL, hemoglobin level before surgery was 10.3 1.7 g/dL, hemoglobin level during surgery was 11.0 1.5 g/dL, and hemoglobin level after the last transfusion was 12.3 2.4 g/dL. Time to extubation was 12 3.3 h, and inotropic support was enoximone in 37 patients,whereas 6 patients needed enoximone and epinephrine.No patient needed reexploration for bleeding and one patient received a platelet transfusion.The mean blood transfusion volume was equivalent to 60% of the patient’s total blood volume (estimated to be 80 mL/kg).
本研究旨在测量一名儿科患者住院期间所需同源血液量。在 4 个月的时间里，所有接受过血液预充或在住院期间需要输血的患者都纳入本研究。体外循环方案采用微型旁路回路、真空辅助静脉引流和微灌注。每个打开的血液制品的体积是已知的，并且在最后一次输血后测量剩余的血液制品体积。收集的数据包括：患者体重；手术前、体外循环期间和最后一次输血后重症监护期间的血红蛋白水平；拔管时间；以及正性肌力支持程度。本研究纳入了 46 名体重为 5.1 1.5kg 的患者。体重在 3.5kg 以下的患者体外循环预充量为 100ml，体重在 3.6 至 7.5kg 之间的患者为 120ml，体重在 7.6 至 8.6kg 之间的患者为 160ml。输血量为 271 112ml，手术前血红蛋白水平为 10.3 1.7g/dL，手术期间血红蛋白水平为 11.0 1.5g/dL，最后一次输血后血红蛋白水平为 12.3 2.4g/dL。拔管时间为 12 3.3 小时，37 例患者使用了艾司莫林，6 例患者需要使用艾司莫林和肾上腺素。没有患者因出血需要再次探查，1 例患者接受了血小板输注。平均输血量相当于患者总血容量的 60%（估计为 80ml/kg）。
