Clinical Study Of Anemia On Admission And Hemoglobin Changes During Hospitalization In Infants With Left To Right Shunt Congenital Heart Disease

Objective: To study the prevalence of anemia in infants with left to right shunt congenital heart disease,the relationship between anemia and prognosis in hospital,and to find out the risk factors of hemoglobin decline during hospitalization.Methods: 151 children with congenital heart disease who were discharged from our department from January 2017 to December 2020 were retrospectively analyzed.According to the admission hemoglobin level and anemia threshold of different ages,these children were divided into anemia group and non-anemia group.The age,gender and other general information,hospitalization process and clinical outcome of the children were compared.The degree of hemoglobin decline during hospitalization was divided into less than or equal to 10 g / L,greater than 10 g / L,less than or equal to 20 g /L and greater than 20 g / L.The clinical outcomes were compared and the high-risk factors of hemoglobin decline were analyzed.Results: 51.7% of the children were complicated with anemia.The age of anemia group was lower than that of non-anemia group(P < 0.001),the PELOD-2 score of anemia group was higher(P = 0.047),the albumin level was lower(P < 0.001),the proportion of patients with multiple heart defects is higher(P=0.007)and the proportion of blood transfusion was higher(P = 0.040).Compared with patients whose hemoglobin decreased more than 20 g / L and less than or equal to 20 g / L,patients with hemoglobin decreased more than 10 g / l had higher PELOD-2 score(P = 0.006),higher Ross score(P = 0.027),higher pro-BNP level(0.008),higher CK-MB level(P = 0.028),higher use of diuretics(P= 0.005),higher use of vasoactive drugs(P = 0.003)and longer hospital stay(P = 0.003),less mechanical ventilation(P = 0.004),and lower hematocrit(P = 0.020)in patients with hemoglobin decrease more than 20 g / L than in patients with hemoglobin decrease less than 10 g / L.Patients with hemoglobin drop of more than 20g/l,the cumulative blood collection volume was more than that of the other two groups of patients(P < 0.001).Conclusion: Anemia is common in infants with left to right shunt congenital heart disease.Younger age,higher pelod-2 score and multiple heart defects are associated with anemia.Patients with poor cardiac function and patients with more cumulative blood collection had a greater decrease in hemoglobin during hospitalization.Hemoglobin decline is associated with poor prognosis,indicating the use of vasoactive drugs and longer hospital stay.