Effects of Circuit Residual Volume Salvage Reinfusion on the Postoperative Clinical Outcome for Pediatric Patients Undergoing Cardiac Surgery

This study aimed to evaluate the effects of washed cardiopulmonary (CPB)
circuit residual blood reinfusion on the postoperative clinical outcome
for pediatric patients undergoing cardiac surgery. A total of 309
consecutive Chinese cardiac patients receiving CPB between October 2010
and April 2011 were prospectively analyzed. For 217 patients, CPB
circuit residual blood was reinfused after the cell-saving procedure
[cell-salvage group (CS)]. The remaining 92 patients were directly
transfused with allogenic red blood cells (RBCs) after their operation
[control group (CON)]. Assessment included perioperative transfusion of
RBCs, postoperative hematocrit (HCT), chest tube drainage during the
first 24 h after the operation, intrahospital mortality, respiratory
morbidity, and renal dysfunction. The two groups were well matched in
terms of demographics, CPB data, and complexity of surgical procedure.
The patients in the CS group had a significantly higher HCT level
postoperatively (p = 0.018) and a less allogenic RBCs transfusion
(p = 0.000). The two groups did not differ in terms of chest tube
drainage during the first 24 h postoperatively, intrahospital mortality,
or respiratory morbidity. The incidence of serum creatinine (≥2-folds)
during the first 72 h after the operation was significantly lower in the
CS group (2.3 %) than in the CON group (8.7 %) (p = 0.010). Reinfusion
of washed CPB circuit residual blood significantly raised the
postoperative HCT level, reduced the allogeneic blood transfusion,
decreased the incidence of early postoperative renal dysfunction, and
did not increase the chest tube drainage after the operation in
pediatric cardiac surgery.