1.
Effect of Two Different Colloid Priming Strategies in Infants Weighing Less Than 5 kg Undergoing On-pump Cardiac Surgeries
Zhou C, Tong Y, Feng Z, Cui Y, Zhao M, Hu J, Liu K, Zhao J, Liu J
Artificial organs. 2019
Abstract
OBJECTIVES To explore the effect of two different priming strategies (artificial colloid only vs. artificial colloid combined with human serum albumin) on the prognosis of children weighing less than 5 kg undergoing on-pump congenital heart disease (CHD) surgery. METHODS A total of 65 children weighing less than 5 kg who underwent on-pump CHD surgery in our hospital from September 2016 to December 2017 were enrolled in this study. The children were randomly divided into two groups: artificial colloid priming group (AC group, n=33) and artificial colloid combined albumin priming group (ACA group, n=32). The primary clinical endpoint was the peri-CPB colloid osmotic pressure (COP). Secondary clinical endpoints included perioperative blood product & hemostatic drug consumption, postoperative renal function, coagulation function, postoperative renal function and postoperative recovery parameters. RESULTS COP values were not significant in the priming system as well as peri-CPB time points between the two groups (P>0.05). Platelet consumption in the AC group was significantly lower than that in the ACA group (P<0.05). There were no significant differences in the use of other blood products and hemostatic drugs as well as perioperative coagulation parameters between the two groups (P>0.05). Postoperative length of stay in the AC group was significantly lower than that in the ACA group (P<0.05). There were no significant differences in mortality, postoperative mechanical ventilation time, ICU time and perioperative adverse event (including postoperative AKI) occurrences between the two groups (P>0.05). CONCLUSIONS In the on-pump cardiac surgeries of patients weighting less than 5kg, total colloidal priming would not affect peri-CPB COP values, postoperative coagulation function and blood products consumption. Total artificial colloidal priming strategy is feasible in low-weight patients.
2.
Tranexamic acid reducing blood transfusion in children undergoing craniosynostosis surgery
Song G, Yang P, Zhu S, Luo E, Feng G, Hu J, Li J, Li Y
Journal of Craniofacial Surgery. 2013;24((1):):299-303.
Abstract
BACKGROUND Surgical correction of craniosynostosis in children is associated with substantial intraoperative bleeding. Intraoperatively administered tranexamic acid (TXA) can lessen blood loss during orthopedic and cardiovascular surgery, but its efficacy in craniosynostosis surgery is uncertain. Therefore, a meta-analysis performed with published comparative studies was to determine whether TXA could reduce packed red blood cells (or erythrocytes) (PRBCs) transfused and blood loss during pediatric craniosynostosis surgery. METHODS Two PubMed and EMBASE electronic databases were searched until June 2012. Eligible studies were restricted in comparative controlled trials. RESULTS Four studies in 3 articles with 138 patients were included. The results showed that intraoperative administration of TXA can significantly reduce transfusion of PRBCs (weighed mean difference [WMD] = -10.81, 95% confidence interval [CI] = -16.84 to -4.78, P < 0.00001). In the level of blood loss, the meta-analysis on 4 studies showed that the difference was statistically significant (WMD = -20.53, 95% CI = -32.26 to -8.80, P = 0.0006) between the TXA groups and the control groups. However, the subgroup analysis on randomized controlled trials showed that TXA did not significantly reduce blood loss during surgery compared with the placebo group (WMD = -30.79, 95% CIs = -71.72 to 10.14, P = 0.14). CONCLUSIONS Tranexamic acid can significantly reduce the transfusion of PRBCs in children undergoing craniosynostosis surgery. However, there is a controversy on the efficacy of TXA in reducing blood loss. Therefore, new randomized controlled trials to assess the effects of TXA in children with craniosynostosis surgery should be conducted. Journal Article.