Patient Blood Management in Pediatric Cardiac Surgery

Abstract

ABSTRACT Children undergoing open heart surgery are often exposed to allogeneic blood products due to developmental changes in their haemostatic system and inflammation, use of anticoagulants, haemodilution and coagulopathy due to CPB. The complexity of surgical procedures, complex cardiopulmonary interactions and the risk of inadequate oxygen delivery and postoperative bleeding increase the use of blood products. Patient blood management aimed at minimising blood product transfusion is associated with improved patient outcomes. Safe conservative blood management practices covering the pre-, intra- and postoperative periods result in reduced blood product transfusion. This review summarises the current evidence on anaemia management and blood transfusion practices in the perioperative care of children undergoing cardiac surgery.

Keywords

• pediatrics
• patient blood management
• cardiopulmonary bypass

Pediyatrik kalp cerrahisinde hasta kan yönetimi

Öz

Açık kalp ameliyatı geçiren pediatrik hastalar, hemostatik sistemlerindeki gelişimsel değişiklikler ve kardiyopulmoner bypassa bağlı inflamasyon, antikoagülan kullanımı, hemodilüsyon ve koagülopati nedeniyle sıklıkla allojenik kan ürünlerine maruz kalmaktadır. Cerrahi prosedürlerin karmaşıklığı, kompleks kardiyopulmoner etkileşimler, yetersiz oksijen iletimi ve postoperatif kanama riski kan ürünlerinin kullanımını arttırmaktadır. Kan ürünü transfüzyonunu en aza indirmeyi amaçlayan hasta kan yönetimi, aynı zamanda daha iyi klinik sonuçlarla ilişkilidir. Ameliyat öncesi, sırası ve sonrası dönemi kapsayan güvenli konservatif kan yönetimi uygulamaları, kan ürünü transfüzyonunun azalmasıyla sonuçlanmaktadır. Bu derleme, kalp ameliyatı geçiren çocukların perioperatif bakımında anemi yönetimi ve kan transfüzyonu uygulamalarına ilişkin mevcut kanıtları özetlemektedir.

Anahtar Kelimeler

• pediyatrik hasta
• hasta kan yönetimi
• kardiyopulmoner bupass

Kaynakça

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