Benefits and risks of red blood cell transfusion in pediatric patients undergoing cardiac surgery

摘要: As the number of neonates and young infants undergoing cardiac surgery requiring cardiopulmonary bypass (CPB) increases, red blood cell (RBC) transfusion will continue to be an integral part practice pediatric anesthesiology. The decision when transfuse RBCs these patients is complex influenced by multiple factors such as size, presence cyanotic heart disease, complexity surgical procedure, hemostatic alterations induced CPB. known benefits RBC include increase in oxygen-carrying capacity blood, improved tissue oxygenation, hemostasis. Unfortunately, there no minimum hemoglobin level that serves a trigger for all surgery. Physiologic signs tachycardia, hypotension, low mixed venous oxygen saturation increased extraction ratios can provide objective evidence need augment given level. Nevertheless, must balanced against its risks and, recent years, has been subjected intense scrutiny. adverse consequences transmission infectious diseases immune-mediated nonimmune-mediated complications. Advances donor selection, disease testing donated use leukocyte reduction irradiation defined situations have safety supply terms infection transmission. However, growing prospective randomized clinical trials are finding association between risk morbidity mortality even with leuko-reduced blood. Thus, it becoming increasingly important made thorough understanding benefit-to-risk ratio. This review addresses transfusion, pertinent data acquired setting congenital techniques designed minimize transfusion.