The Effect of Preprocessing Stored Red Blood Cells on Neonates Undergoing Corrective Cardiac Surgery

Background: This study compared the effect of unprocessed and processed packed red blood cells (PRBCs) with the continuous autotransfusion system (CATS) during neonate heart surgery.

Methods: Sixteen neonatal patients undergoing cardiac surgery were randomly divided into two groups: unprocessed PRBC (C group, n = 8); processed PRBC (P group, n = 8). The CATS was employed perioperatively. Series laboratory and clinical parameters, including levels of hematocrit, blood potassium, blood glucose, blood lactate, acid-base, and total priming volume of PRBC, were used to compare the effect between the two groups.

Results: Before CPB, the hematocrit of processed PRBCs in P group was significantly higher than those in C group (p < 0.01), and the concentrations of potassium, blood glucose, and lactate of processed PRBCs in P group were significantly lower than those in C group (p < 0.01). At the beginning and the end of CPB, the hematocrit levels in P group were all higher than those in C group (p < 0.05); lactate levels in P group were significantly lower than those in C group at the beginning of CPB (p < 0.01), and lower than that of C group at the end of CPB (p < 0.05). The total priming of PRBCs in P group was significantly less than that in C group (p < 0.01).

Conclusion: Perioperative processing with CATS provided a high-quality RBC concentration, decreased the total priming of PRBCs, providing increased high-quality blood salvage during neonatal CPB procedure.