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首页> 外文期刊>European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery >The indication for perioperative red blood cell transfusions is a predictive risk factor for severe postoperative morbidity and mortality in children undergoing cardiac surgery
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The indication for perioperative red blood cell transfusions is a predictive risk factor for severe postoperative morbidity and mortality in children undergoing cardiac surgery

机译：围手术期红细胞输血的指示是术后术后发病率和心脏手术中儿童死亡率的预测危险因素

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Objectives: In paediatric cardiac surgery, red blood cell (RBC) transfusions are given to treat haemorrhage or to increase oxygen delivery (therapeutic transfusion). Sometimes, RBCs are added to the prime solution to avoid a too low haematocrit on bypass (CPB-driven transfusion). Our study investigated whether the reason for RBC transfusion might affect severe postoperative morbidity or mortality. Methods: This retrospective cohort study was conducted in a tertiary care level, children's hospital. The charts of all patients admitted between 2006 and 2009 were reviewed. Among transfused patients, children receiving a therapeutic transfusion were compared with those receiving a CPB-driven transfusion. The primary outcome was severe postoperative morbidity or mortality. Statistically significant variables founded with univariate analysis were incorporated in the multivariable logistic regression analysis to build a model that predicts severe postoperative morbidity or mortality. This model was then adjusted for clinically relevant variables that may interfere with 'indication for transfusion'. Results: One hundred and one (48%) patients in the therapeutic and 92 (26%) patients in the CPB-driven transfusion group developed severe postoperative morbidity or died (P < 0.001). A multivariable logistic regression showed that weight, ASA, calculated blood loss, intraoperative fluid balance, duration of CPB time and the indication group for transfusion [1.64 (1.03-2.62); P = 0.039] were independent risk factors for severe postoperative morbidity or mortality. The indication group for transfusion remained significant [2.0 (1.16-3.45); P = 0.013] after adjustment for significant predictors of indication for transfusion. Number of patients with infections, or neurological deficit, and length of mechanical ventilation, PICU and hospital length of stay, were significantly higher in the therapeutic compared with the CPB-driven transfusion group one. Conclusions: The indication group for transfusion has an impact on the occurrence of severe postoperative morbidity or mortality in children undergoing cardiac surgery.
机译：目的：在儿科心脏手术中，给予红细胞（RBC）输血治疗出血或增加氧递送（治疗输血）。有时，RBC被添加到素溶液中，以避免旁路（CPB驱动输血）上过低的血细胞比容。我们的研究调查了RBC输血的原因是否可能影响严重的术后发病率或死亡率。方法：这项回顾性队列研究在儿童医院进行三级护理水平进行。审查了2006年至2009年间患者的所有患者的图表。在转育患者中，将接受治疗输血的儿童与接受CPB驱动的输血的人进行比较。主要结果是术后发病率或死亡率。在多变量分析中创立的统计学显着的变量始于多变量的逻辑回归分析中，以构建预测严重术后发病率或死亡率的模型。然后调整该模型的临床相关变量，可能会干扰“输血的指示”。结果：CPB驱动输血组中治疗性和92例（26％）患者的一百（48％）患者显得严重术后发病率或死亡（P <0.001）。多变量的逻辑回归显示重量，ASA，计算出血损失，术中流体平衡，CPB持续时间和输血的指示群[1.64（1.03-2.62）; P = 0.039]是严重术后发病率或死亡率的独立风险因素。输血的指示群保持重要[2.0（1.16-3.45）;在调整输血指示的显着预测因子后，P = 0.013]。与CPB驱动的输血组相比，治疗患者的感染患者或机械通气的神经缺陷和长度的患者数量显着高于治疗。结论：输血的指示群对接受心脏手术的儿童严重术后发病率或死亡率的影响。

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