Red blood cell (RBC) transfusion may benefit a subset of patients in whom a low hemoglobin concentration contributes to a state of oxygen-supply dependency. The RBC transfusion is not without risk, and recent data suggest an association between transfusion and poor outcome in critically ill adults. Children undergoing cardiac surgery are frequently exposed to blood products. The association of blood transfusion and postoperative morbidity and mortality has not been well elucidated. We are currently evaluating the association of packed red blood cell (PRBC) transfusion with morbidity among pediatric cardiac surgical patients, and the effect of blood conservation surgery on outcome.
We have been practicing blood conservation cardiac surgery in children for the last three years, using sophisticated heart-lung bypass support and other equipment at the Augusta University Children's Hospital of Georgia. We are the only center in the state of Georgia and surrounding regions that has been aggressively implementing blood conservation surgery to decrease or eliminate children's exposure to blood products, and to improve their operative and long-term outcome. The primary goal of this study is to examine the relationship of PRBC transfusion on complications, amount of heart medications, ventilator days and hospital length of stay in a single center with a heterogeneous population of pediatric cardiac surgical patients. We have demonstrated that patients requiring lower and no blood transfusion also have lower need for heart medications, less need for ventilator support, lower complication rate, and a much shorter length of stay in the hospital.