E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass

Varuna Varma, Nirmal Gupta, Prabhaker Mishra.

Abstract
Background: Cardiopulmonary bypass (CPB) induced hemodilution and coagulopathies are important causes of perioperative bleeding following heart surgeries results both in pediatric and adult patients. However, this is more pronounced in children undergoing intracardiac repair procedures due to the weight (body mass) versus blood volume mismatch in children and inherently built-in requirement of the priming volume in the bypass circuit.

Objectives: The objectives of the study were to observe and compare the impact of differing allogenic blood transfusion practices between the four groups of children under 18 years in the same institution.

Materials and Methods: A total of 791 children (excluding neonates) underwent open-heart surgery in our institute by two different surgeons (A and B) during 20062012, each following different perioperative packed red blood cell (PRBC) or blood product transfusion protocols for their patients. Children were categorized into 2 equal and matched groups in terms of their numbers (in each category of similar type of surgery). Surgeon-A, operated all children in Group A (n = 396), received with hemoglobin (Hb) ≤7 g/dl further divided into Groups 1 and 2 while Group B (n = 396) operated equal numbers in empirical transfusion protocol was followed, received with Hb ≤10 g/dl further divided into Groups 3 and 4 based on transfusion received or not received. Restricted and targeted PRBC transfusion criteria were followed in all children.

Results: Transfusion was required more often in critical and sick children and in those who have had longer CPB for complex repairs. 57.8% of children in Group B received either or both PRBC and blood product transfusion during its hospital stay. Logistic regression revealed that after adjusting the effect of their age, total chest, hospital stay, and ventilator time, had higher risk of mortality in the Group 1 (8.68, P < 0.001), Group 2 (1.38, P = 0.458), and Group 3 (5.17, P < 0.001) in contrast with Group 4 (no transfusion, Hb >10 g/dl).

Conclusion: PRBC or blood product transfusions in perioperative period adversely affect the post-operative outcomes; period of hospitalization, duration of recovery (morbidity), and survival (mortality) in children under 18 years.

Key words: Perioperative Bleeding; Hemodilution, Empirical; Restricted Blood Transfusion


 
ARTICLE TOOLS
Abstract
PDF Fulltext
Print this article Print this Article
How to cite this articleHow to cite this article
Export to
Export to
Related Records
 Articles by Varuna Varma
Articles by Nirmal Gupta
Articles by Prabhaker Mishra
on Google
on Google Scholar
Article Statistics
 Viewed: 195
Downloaded: 85
Cited: 0

How to Cite this Article
Pubmed Style

Varma V, Gupta N, Mishra P. Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. Int J Med Sci Public Health. 2018; 7(7): 559-565. doi:10.5455/ijmsph.2018.0409812042018


Web Style

Varma V, Gupta N, Mishra P. Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. http://www.ijmsph.com/?mno=295419 [Access: July 18, 2018]. doi:10.5455/ijmsph.2018.0409812042018


AMA (American Medical Association) Style

Varma V, Gupta N, Mishra P. Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. Int J Med Sci Public Health. 2018; 7(7): 559-565. doi:10.5455/ijmsph.2018.0409812042018



Vancouver/ICMJE Style

Varma V, Gupta N, Mishra P. Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. Int J Med Sci Public Health. (2018), [cited July 18, 2018]; 7(7): 559-565. doi:10.5455/ijmsph.2018.0409812042018



Harvard Style

Varma, V., Gupta, N. & Mishra, P. (2018) Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. Int J Med Sci Public Health, 7 (7), 559-565. doi:10.5455/ijmsph.2018.0409812042018



Turabian Style

Varma, Varuna, Nirmal Gupta, and Prabhaker Mishra. 2018. Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. International Journal of Medical Science and Public Health, 7 (7), 559-565. doi:10.5455/ijmsph.2018.0409812042018



Chicago Style

Varma, Varuna, Nirmal Gupta, and Prabhaker Mishra. "Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass." International Journal of Medical Science and Public Health 7 (2018), 559-565. doi:10.5455/ijmsph.2018.0409812042018



MLA (The Modern Language Association) Style

Varma, Varuna, Nirmal Gupta, and Prabhaker Mishra. "Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass." International Journal of Medical Science and Public Health 7.7 (2018), 559-565. Print. doi:10.5455/ijmsph.2018.0409812042018



APA (American Psychological Association) Style

Varma, V., Gupta, N. & Mishra, P. (2018) Perioperative transfusions adversely affect post-operative outcomes in less than 18-year undergoing surgical repairs on cardiopulmonary bypass. International Journal of Medical Science and Public Health, 7 (7), 559-565. doi:10.5455/ijmsph.2018.0409812042018





Most Viewed Articles
  • Management of Appendicular Lump: Early exploration Vs conservative management
    Chandra Prakash Pandey, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, Arshad Raza
    Int J Med Sci Public Health. 2013; 2(4): 1046-1049
    » Abstract & References » doi: 10.5455/ijmsph.2013.230820131

  • Burden of non communicable diseases in India: Setting priority for action
    Kalpa Sharma
    Int J Med Sci Public Health. 2013; 2(1): 7-11
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.7-11

  • Internet addiction among professional courses students: A study from central India
    Arvind Sharma, Rupesh Sahu, Pradeep Kumar Kasar, Richa Sharma
    Int J Med Sci Public Health. 2014; 3(9): 1069-1073
    » Abstract & References » doi: 10.5455/ijmsph.2014.180620142

  • Diabetic nephropathy: Progression and pathophysiology
    Deepak N Parchwani, Amit A Upadhyah
    Int J Med Sci Public Health. 2012; 1(2): 59-70
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.59-70

  • Elevated levels of serum uric acid, creatinine or urea in preeclamptic women
    Magna Manjareeka, Sitikantha Nanda
    Int J Med Sci Public Health. 2013; 2(1): 43-47
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.43-47

  • Maternal and fetal outcome in oligohydramnios- Study of 100 cases
    Krishna Jagatia, Nisha Singh, Sachin Patel
    Int J Med Sci Public Health. 2013; 2(3): 724-727
    » Abstract & References » doi: 10.5455/ijmsph.2013.070520132

  • Zinc: The trace element of major importance in human nutrition and health
    Jayant D Deshpande, Mohini M Joshi, Purushottam A Giri
    Int J Med Sci Public Health. 2013; 2(1): 1-6
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.1-6

  • Knowledge, Attitude, and Practices (KAP) study on HIV / AIDS among HIV patients, care givers and general population in north-eastern part of India.
    L P Meena, S K Pandey, M Rai, Anju Bharti, Shyam Sunder
    Int J Med Sci Public Health. 2013; 2(1): 36-42
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.36-42

  • Patient satisfaction about health care services: A cross sectional study of patients who visit the outpatient department of a civil hospital at Surendranagar, Gujarat
    Krupal Joshi, Kishor Sochaliya, Shyamal Purani, Girija Kartha
    Int J Med Sci Public Health. 2013; 2(3): 659-663
    » Abstract & References » doi: 10.5455/ijmsph.2013.250420131

  • Prevalence and pattern of substance abuse among school childern in nothern India: A rapid assesment study
    Syed Shuja Qadri, RKD Goel, Jagjeet Singh, Surendra Kumar Ahluwalia, Rambha Pathak, Humaira Bashir
    Int J Med Sci Public Health. 2013; 2(2): 273-282
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.271-280

  • Most Downloaded
  • Internet addiction among professional courses students: A study from central India
    Arvind Sharma, Rupesh Sahu, Pradeep Kumar Kasar, Richa Sharma
    Int J Med Sci Public Health. 2014; 3(9): 1069-1073
    » Abstract & References » doi: 10.5455/ijmsph.2014.180620142

  • Diabetic nephropathy: Progression and pathophysiology
    Deepak N Parchwani, Amit A Upadhyah
    Int J Med Sci Public Health. 2012; 1(2): 59-70
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.59-70

  • Burden of non communicable diseases in India: Setting priority for action
    Kalpa Sharma
    Int J Med Sci Public Health. 2013; 2(1): 7-11
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.7-11

  • Gunthers with haemolytic anaemia extremly rare: A case report
    Nilesh Kumar, Ankur Varshney, Arvind Anand, Dibyaranjan Behera, Ravi Anand, Ashutosh Tiwari
    Int J Med Sci Public Health. 2013; 2(2): 472-474
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.313-315

  • Zinc: The trace element of major importance in human nutrition and health
    Jayant D Deshpande, Mohini M Joshi, Purushottam A Giri
    Int J Med Sci Public Health. 2013; 2(1): 1-6
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.1-6

  • Knowledge, Attitude, and Practices (KAP) study on HIV / AIDS among HIV patients, care givers and general population in north-eastern part of India.
    L P Meena, S K Pandey, M Rai, Anju Bharti, Shyam Sunder
    Int J Med Sci Public Health. 2013; 2(1): 36-42
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.36-42

  • Recent update on osteoporosis
    Vijender Agrawal, Dharmendra Gupta
    Int J Med Sci Public Health. 2013; 2(2): 164-168
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.162-166

  • Maternal and fetal outcome in oligohydramnios- Study of 100 cases
    Krishna Jagatia, Nisha Singh, Sachin Patel
    Int J Med Sci Public Health. 2013; 2(3): 724-727
    » Abstract & References » doi: 10.5455/ijmsph.2013.070520132

  • Study of psychological stress among undergraduate medical students of government medical college, Surat.
    Priti Solanky, Binita Desai, Abhay Kavishwar, S. L. Kantharia
    Int J Med Sci Public Health. 2012; 1(2): 38-42
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.38-42

  • Patient satisfaction about health care services: A cross sectional study of patients who visit the outpatient department of a civil hospital at Surendranagar, Gujarat
    Krupal Joshi, Kishor Sochaliya, Shyamal Purani, Girija Kartha
    Int J Med Sci Public Health. 2013; 2(3): 659-663
    » Abstract & References » doi: 10.5455/ijmsph.2013.250420131

  • Most Cited Articles
  • Zinc: The trace element of major importance in human nutrition and health
    Jayant D Deshpande, Mohini M Joshi, Purushottam A Giri
    Int J Med Sci Public Health. 2013; 2(1): 1-6
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.1-6
    Cited : 21 times [Click to see citing articles]

  • Burden of non communicable diseases in India: Setting priority for action
    Kalpa Sharma
    Int J Med Sci Public Health. 2013; 2(1): 7-11
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.7-11
    Cited : 13 times [Click to see citing articles]

  • Non albicans Candida species: its isolation pattern, species distribution, virulence factors and antifungal susceptibility profile
    Sachin Chandrakant Deorukhkar, Santosh Saini
    Int J Med Sci Public Health. 2013; 2(3): 533-538
    » Abstract & References » doi: 10.5455/ijmsph.2013.080320131
    Cited : 6 times [Click to see citing articles]

  • Clinico-microbiological profile of women with vaginal discharge in a tertiary care hospital of northern India
    Varsha Chaudhary, Ved Prakesh, Kian Agarwal, Vijender Kumar Agrawal, Arun Singh, Sachin Pandey
    Int J Med Sci Public Health. 2012; 1(2): 75-80
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.75-80
    Cited : 5 times [Click to see citing articles]

  • Correlation between obesity and cardio respiratory fitness
    Prabha Setty, BV Padmanabha, BR Doddamani
    Int J Med Sci Public Health. 2013; 2(2): 300-304
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.298-302
    Cited : 5 times [Click to see citing articles]

  • Knowledge, Attitude, and Practices (KAP) study on HIV / AIDS among HIV patients, care givers and general population in north-eastern part of India.
    L P Meena, S K Pandey, M Rai, Anju Bharti, Shyam Sunder
    Int J Med Sci Public Health. 2013; 2(1): 36-42
    » Abstract & References » doi: 10.5455/ijmsph.2013.2.36-42
    Cited : 5 times [Click to see citing articles]

  • Prevalence and clinical characteristics of autism spectrum disorders in school-age children in Taif- KSA
    Ali H.S Al-Zahrani
    Int J Med Sci Public Health. 2013; 2(3): 578-582
    » Abstract & References » doi: 10.5455/ijmsph.2013.160420133
    Cited : 5 times [Click to see citing articles]

  • Electrocardiographic changes during acute mental stress
    Arpana Bhide, Rajasekhar Durgaprasad, Latheef Kasala, Vanajakshamma Velam, Narendra Hulikal
    Int J Med Sci Public Health. 2016; 5(5): 835-838
    » Abstract & References » doi: 10.5455/ijmsph.2016.19082015137
    Cited : 5 times [Click to see citing articles]

  • Importance of cardiac marker enzymes (Aspartate transaminase and troponin I) in acute myocardial infarction: A case-control study from South India
    Vuddandi Prabodh, Deva Prakash, Godi Sudhakar, Yeruva Reddy, Nadella Chowdary, Sripada Desai, Ravi Shekhara
    Int J Med Sci Public Health. 2012; 1(2): 118-120
    » Abstract & References » doi: 10.5455/ijmsph.2012.1.118-120
    Cited : 4 times [Click to see citing articles]

  • Role of HRCT temporal bone in pre operative evaluation of choesteatoma
    Chintan Shah, Pinal Shah, Satish Shah
    Int J Med Sci Public Health. 2014; 3(1): 69-72
    » Abstract & References » doi: 10.5455/ijmsph.2013.031020131
    Cited : 4 times [Click to see citing articles]