A retrospective study of intraoperative blood transfusion in children with congenital heart disease

This study aims to analyze the characteristics and influencing factors of intraoperative blood transfusion in children with congenital heart disease (CHD) and explore the preoperative blood preparation protocols and risk indicators for intraoperative blood transfusion. It retrospectively analyzed data from 243 patients under the age of 18 undergoing CHD surgery from December 2018 to March 2022. The patients were divided into four groups in terms of the following surgical methods: ventricular septal defect (VSD) repair (group A), atrial septal defect (ASD) repair (group B), VSD and ASD repair (group C), and others (group D). Influencing factors for intraoperative blood transfusion in different surgical methods and outcomes were assessed. (1) Among the 243 cases, 185 (76.13%) cases received intraoperative blood transfusion, 176 (72.43%) cases received red blood cell (RBC) transfusion, and 30 (12.35%) cases received plasma transfusion. The RBC transfusion rate of group C was 91.21%, which was significantly higher than those of the other three groups (P<0.05). The plasma transfusion rate of group D was 24.32%, which was significantly higher than those of the other three groups (P<0.05). (2) There was no significant difference in the volume of RBC preparation, intraoperative blood loss, intraoperative RBC transfusion, and postoperative hemoglobin (Hb) between the four groups (P>0.05). The preoperative weight and Hb of group C were lower than those of the other three groups; however, only the difference between group B and group C was statistically significant (P<0.05). (3) The influencing factors for intraoperative RBC transfusion, such as age, preoperative weight, and Hb, were negatively correlated in the four groups. (4) No adverse reactions of blood transfusion were found in the four groups. The postoperative infection rates of group C and group D were 31.33% and 29.73%, respectively, which were higher than those of group A and group B (9.72% and 16.28%, respectively) (P<0.05). The average duration of hospitalized days of group C and group D were higher than those of group A and group B (P<0.05). This study suggests that the individualized blood preparation should be achieved according to the characteristics of intraoperative blood transfusion in children with CHD and the evaluation of the risk of intraoperative blood transfusion.