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小儿心脏手术中的术前自体血捐献

Preoperative autologous blood donations in pediatric cardiac surgery.

作者信息

Masuda M, Kawachi Y, Inaba S, Matsuzaki K, Fukumura F, Morita S, Tominaga R, Yasui H

机构信息

Department of Cardiovascular Surgery and Blood Transfusion Service, Kyushu University Hospital, Kyushu University, Fukuoka, Japan.

出版信息

Ann Thorac Surg. 1995 Dec;60(6):1694-7. doi: 10.1016/0003-4975(95)00715-6.

Abstract

BACKGROUND

Preoperative autologous blood donation is one of the most effective methods to avoid homologous blood transfusion in cardiac operations. However, there have been few reports about the safety and efficacy of autologous blood donation in children.

METHODS

Since 1986, we have instituted a blood conservation program including preoperative autologous blood donations in children. Eighty children as young as 3 years old (mean +/- SD, 8.6 +/- 3.9 years) and weighing as little as 12.3 kg (29.2 +/- 14.5 kg) were enrolled in the program, and 735 +/- 388 mL of blood was donated during an average of 3.1 +/- 1.5 phlebotomies before the operations.

RESULTS

Two episodes of mild vasovagal reaction were observed in 2 patients as a complication of the phlebotomy. Seventy-six percent of the collected blood was stored by cryopreservation; the remaining 24% was preserved by liquid storage. Seventy-eight of these patients (97.5%) underwent operations using cardiopulmonary bypass. Seventy-five patients (94%) were operated on successfully without the need for a homologous blood transfusion. As for the other 5 patients, 2 received only platelet concentrate.

CONCLUSION

Preoperative autologous blood donation is a safe and effective method to avoid homologous blood transfusion in pediatric cardiac operations.

摘要

背景

术前自体血捐献是心脏手术中避免异体输血最有效的方法之一。然而,关于儿童自体血捐献的安全性和有效性的报道很少。

方法

自1986年以来,我们制定了一项血液保护计划,包括儿童术前自体血捐献。该计划纳入了80名年龄小至3岁(平均±标准差,8.6±3.9岁)、体重轻至12.3 kg(29.2±14.5 kg)的儿童,术前平均进行3.1±1.5次采血,共捐献血液735±388 mL。

结果

2例患者在采血过程中出现2次轻度血管迷走神经反应并发症。所采集血液的76%通过冷冻保存;其余24%通过液体保存。其中78例患者(97.5%)接受了体外循环手术。75例患者(94%)手术成功,无需异体输血。另外5例患者中,2例仅接受了浓缩血小板。

结论

术前自体血捐献是小儿心脏手术中避免异体输血的一种安全有效的方法。

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