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Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit
Objective- We aimed to describe the use of blood products following cardiac surgery, as well as the outcomes and factors associated with post-operative blood product use Design- Prospective, single centre observational study Setting- Paediatric intensive care unit (PICU) in Cape Town, South Africa...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2019
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| _version_ | 1867613273946324992 |
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| access_status_str | Open Access |
| author | Fitzwanga, Kaiser |
| author2 | Salie, S |
| author_browse | Fitzwanga, Kaiser Salie, S |
| author_facet | Salie, S Fitzwanga, Kaiser |
| author_sort | Fitzwanga, Kaiser |
| collection | Thesis |
| description | Objective- We aimed to describe the use of blood products following cardiac surgery, as well as the outcomes and factors associated with post-operative blood product use
Design- Prospective, single centre observational study
Setting- Paediatric intensive care unit (PICU) in Cape Town, South Africa
Patients- One hundred and twenty-six children <18 years old admitted to the PICU following cardiac surgery between July 2017 and January 2018
Interventions- None
Measurements and Main Results- The data was prospectively obtained from blood bank charts, intraoperative and PICU observation charts. Demographic data, intraoperative details and post-operative blood product use were extracted from patient records and entered in a standardised case record form. Fifty three percent of children received blood products following cardiac surgery. The blood products transfused included cryoprecipitate (30.9%), packed red cells (22.2%), albumin (18.3%), fresh frozen plasma FFP (15.9%) and platelet concentrate (15.1%). Low haemoglobin level was commonest indication (86%) for red cell use. Bleeding was the commonest indication for FFP (70%) and cryoprecipitate (67%) use. Thrombocytopenia was the commonest indication (84%) for platelet use while hypotension episodes were predominant (95%) in those who received albumin. The standardized mortality ratio was 3.1 vs 0, respectively, among transfused versus non-transfused patients (p<0.0001). The median (IQR) duration of PICU stay was 5 (3-11) vs 2 (2-5) days, respectively in those transfused versus non-transfused (p<0.0001). The median (IQR) ventilation duration was 47(22-132) hours vs 20 (6-27) hours, respectively among the transfused versus non-transfused (p=<0.0001). The factors associated with blood-product use post cardiac surgery include previous cardiac surgery, younger age, lower weights, and prolonged coagulation parameters (p=<0.05).
Conclusion- There is high usage of blood products among children post cardiac surgery. The children transfused had a longer ICU stay, ventilation duration, and higher standardized mortality ratio compared to the non-transfused. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/29879 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:31.121Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/29879 Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit Fitzwanga, Kaiser Salie, S Argent, A Morrow, B Paediatric Critical Care Objective- We aimed to describe the use of blood products following cardiac surgery, as well as the outcomes and factors associated with post-operative blood product use Design- Prospective, single centre observational study Setting- Paediatric intensive care unit (PICU) in Cape Town, South Africa Patients- One hundred and twenty-six children <18 years old admitted to the PICU following cardiac surgery between July 2017 and January 2018 Interventions- None Measurements and Main Results- The data was prospectively obtained from blood bank charts, intraoperative and PICU observation charts. Demographic data, intraoperative details and post-operative blood product use were extracted from patient records and entered in a standardised case record form. Fifty three percent of children received blood products following cardiac surgery. The blood products transfused included cryoprecipitate (30.9%), packed red cells (22.2%), albumin (18.3%), fresh frozen plasma FFP (15.9%) and platelet concentrate (15.1%). Low haemoglobin level was commonest indication (86%) for red cell use. Bleeding was the commonest indication for FFP (70%) and cryoprecipitate (67%) use. Thrombocytopenia was the commonest indication (84%) for platelet use while hypotension episodes were predominant (95%) in those who received albumin. The standardized mortality ratio was 3.1 vs 0, respectively, among transfused versus non-transfused patients (p<0.0001). The median (IQR) duration of PICU stay was 5 (3-11) vs 2 (2-5) days, respectively in those transfused versus non-transfused (p<0.0001). The median (IQR) ventilation duration was 47(22-132) hours vs 20 (6-27) hours, respectively among the transfused versus non-transfused (p=<0.0001). The factors associated with blood-product use post cardiac surgery include previous cardiac surgery, younger age, lower weights, and prolonged coagulation parameters (p=<0.05). Conclusion- There is high usage of blood products among children post cardiac surgery. The children transfused had a longer ICU stay, ventilation duration, and higher standardized mortality ratio compared to the non-transfused. 2019-03-01T09:14:24Z 2019-03-01T09:14:24Z 2018 2019-02-25T09:02:33Z Master Thesis Masters MPhil http://hdl.handle.net/11427/29879 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town |
| spellingShingle | Paediatric Critical Care Fitzwanga, Kaiser Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| thesis_degree_str | Master's |
| title | Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| title_full | Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| title_fullStr | Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| title_full_unstemmed | Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| title_short | Transfusion practices among children undergoing cardiac surgery admitted to the Red Cross War Memorial Children's Hospital Paediatrics Intensive Care Unit |
| title_sort | transfusion practices among children undergoing cardiac surgery admitted to the red cross war memorial children s hospital paediatrics intensive care unit |
| topic | Paediatric Critical Care |
| url | http://hdl.handle.net/11427/29879 |
| work_keys_str_mv | AT fitzwangakaiser transfusionpracticesamongchildrenundergoingcardiacsurgeryadmittedtotheredcrosswarmemorialchildrenshospitalpaediatricsintensivecareunit |