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Pediatric Cardiology

, Volume 36, Issue 6, pp 1212–1218 | Cite as

Association of Hematocrit and Red Blood Cell Transfusion with Outcomes in Infants Undergoing Norwood Operation

  • Punkaj GuptaEmail author
  • Caitlin King
  • Lisle Benjamin
  • Timothy Goodhart
  • Michael J. Robertson
  • Jeffrey M. Gossett
  • Gina A. Pesek
  • Rahul DasGupta
Original Article

Abstract

The objective of this study was to investigate the association between red blood cell (RBC) transfusion and hematocrit values with outcomes in infants undergoing Norwood operation. This study included infants ≤2 months of age who underwent Norwood operation with either a modified Blalock–Taussig shunt or a right ventricle-pulmonary artery shunt. Demographics, preoperative, operative, daily laboratory data, and postoperative variables were collected. The primary outcome measures evaluated included mortality, ICU length of stay, length of mechanical ventilation, and days to chest closure. The secondary outcome measures evaluated included lactate levels, estimated glomerular filtration rate, and inotrope score in the first 14 days after heart operation. Cox proportional hazard models were fitted to study the probability of study outcomes as a function of hematocrit values and RBC transfusions after operation. Eighty-nine patients qualified for inclusion. With a median hematocrit of 46 (IQR 44, 49), and a median RBC transfusion of 92 ml/kg (IQR 31, 384) in the first 14 days after operation, 81 (91 %) patients received RBC transfusions. A multivariable analysis adjusted for risk factors, including the age, weight, prematurity, cardiopulmonary bypass and cross-clamp time, and postoperative need for nitric oxide and dialysis, demonstrated no association between hematocrit and RBC transfusion with majority of study outcomes. This single-center study found that higher hematocrit values and increasing RBC transfusions are not associated with improved outcomes in infants undergoing Norwood operation.

Keywords

Hematocrit Infants Congenital heart disease Norwood Blood transfusion 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Punkaj Gupta
    • 1
    • 2
    • 7
    Email author
  • Caitlin King
    • 3
  • Lisle Benjamin
    • 3
  • Timothy Goodhart
    • 3
  • Michael J. Robertson
    • 3
  • Jeffrey M. Gossett
    • 4
  • Gina A. Pesek
    • 5
  • Rahul DasGupta
    • 6
  1. 1.Division of Pediatric CardiologyUniversity of Arkansas Medical SciencesLittle RockUSA
  2. 2.Division of Critical CareUniversity of Arkansas Medical SciencesLittle RockUSA
  3. 3.Department of Medical Education, College of MedicineUniversity of Arkansas Medical SciencesLittle RockUSA
  4. 4.Division of Biostatistics, Department of PediatricsUniversity of Arkansas Medical SciencesLittle RockUSA
  5. 5.Department of Transfusion MedicineUniversity of Arkansas Medical SciencesLittle RockUSA
  6. 6.Division of Pediatric Anesthesia, Department of AnesthesiologyUniversity of Arkansas Medical SciencesLittle RockUSA
  7. 7.College of Medicine, Sections of Pediatric Cardiology and Critical Care Medicine, Arkansas Children’s HospitalUniversity of Arkansas for Medical SciencesLittle RockUSA

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