Patient Blood Management in Pediatric Cardiac Surgery

ABSTRACT Children undergoing open heart surgery are often exposed to allogeneic blood products due to developmental changes in their haemostatic system and inflammation, use of anticoagulants, haemodilution and coagulopathy due to CPB. The complexity of surgical procedures, complex cardiopulmonary interactions and the risk of inadequate oxygen delivery and postoperative bleeding increase the use of blood products. Patient blood management aimed at minimising blood product transfusion is associated with improved patient outcomes. Safe conservative blood management practices covering the pre-, intra- and postoperative periods result in reduced blood product transfusion. This review summarises the current evidence on anaemia management and blood transfusion practices in the perioperative care of children undergoing cardiac surgery.