Use of low titer O whole blood in infants and young children undergoing cardiac surgery with cardiopulmonary bypass

IF 2.5 3区医学 Q2 HEMATOLOGY

Transfusion Pub Date : 2024-09-13 DOI:10.1111/trf.18014

Massimo Griselli, Sameh M. Said, Philip C. Spinella, Michael Evans, Claudia S. Cohn, Nitasha Joyner, Martina Richtsfeld, Kayla Fahey‐Arndt, Julie Welbig, Greg Beilman, Nicole D. Zantek, Marie E. Steiner

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引用次数: 0

Abstract

BackgroundLow titer group O whole blood (LTOWB) is commonly used for severe bleeding in trauma patients. LTOWB may also benefit young children requiring cardiac surgery with cardiopulmonary bypass (CPB) at risk of severe bleeding.Study Design and MethodsIn this retrospective study, children <2 years old who underwent cardiac surgery with CPB were included. Comparisons were performed between those receiving component therapy (CT) versus those receiving LTOWB plus CT (LTOWB+CT). Outcomes included drainage tube (DT) output and total transfusion volumes. Optimization‐based weighting was used for adjusted analyses between groups.ResultsThere were 117 patients transfused with only CT and 127 patients transfused with LTOWB+CT. In the LTOWB+CT group, 66 were Group non‐O and 61 were Group O. Total transfusion volumes given from the start of the operation until the first 24 h in the cardiac intensive care unit was a median (IQR) 41 (10, 93) mL/kg in the CT group and 48 (28, 77) mL/kg in the LTOWB+CT group, (p = .28). Median (IQR) DT output was 22 (15–32) in CT versus 22 (16–28) in LTOWB+CT groups, (p = .27). There were no differences in death, renal failure and a composite of death and renal failure between the two groups, but there were statistically fewer re‐explorations for bleeding in the LTOWB+CT group (p < .001).ConclusionsThe use of LTOWB appears to be safe in <2 years old undergoing cardiac surgery and may reduce re‐explorations for severe bleeding. Large trials are needed to determine the efficacy and safety of LTOWB in this population with severe bleeding.

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在接受心肺旁路心脏手术的婴幼儿中使用低滴度 O 型全血

背景低滴度O型全血（LTOWB）通常用于治疗创伤患者的严重出血。在这项回顾性研究中，纳入了接受心肺旁路（CPB）心脏手术的 2 岁儿童。对接受成分疗法（CT）和接受LTOWB加CT（LTOWB+CT）的患儿进行比较。结果包括引流管（DT）输出量和总输血量。结果仅接受 CT 输血的患者有 117 人，接受 LTOWB+CT 输血的患者有 127 人。在 LTOWB+CT 组中，66 人为非 O 组患者，61 人为 O 组患者。从手术开始到入住心脏重症监护室的前 24 小时，CT 组的总输血量中位数（IQR）为 41（10, 93）毫升/千克，LTOWB+CT 组为 48（28, 77）毫升/千克，（P = .28）。CT 组 DT 输出中位数（IQR）为 22（15-32），LTOWB+CT 组为 22（16-28），（P = .27）。两组在死亡、肾功能衰竭以及死亡和肾功能衰竭的复合情况方面没有差异，但LTOWB+CT组因出血而再次探查的情况在统计学上更少（p <.001）。结论在接受心脏手术的<2岁儿童中使用LTOWB似乎是安全的，并可减少因严重出血而再次探查的情况。需要进行大规模试验，以确定 LTOWB 在这类严重出血人群中的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion 医学-血液学

CiteScore

4.70

自引率

20.70%

发文量

426

审稿时长

1 months

期刊介绍： TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.