Feasibility Study On Rational Application Of Plasma - Free Pre - Filling Strategy In Infant Outdoor Circulation

ObjectiveTo investigate the feasibility of priming strategy without fresh frozen plasma (FFP) during cardiopulmonary bypass (CPB) in pediatric patients undergoing cardiac surgery and identify factors associated with postoperative chest tube drainage.Methods1164 pediatric patients who underwent cardiac surgery with CPB between January 2012 and April 2013 in Fuwai hospital were reviewed. They were divided into the infants FFP group (IF, n=336), the infants Gelofusine group (IG, n=335), the children FFP group (CF, n=225) and the children Gelofusine group (CG, n=268). Priming strategies were compared respectively in infants and children. Clinical data included postoperative coagulation function (pharmacological agents, chest tube drainage, transfusion requirements), recovery indicators (mechanical ventilator time, ICU stay and hospital stay), incidence of in-hospital mortality and morbidity. Multiple linear regression analysis was used to identify factors correlated with postoperative chest tube drainage.Results1. Compared to the IF group, significantly more chest tube drainage of postoperative 12 and 24 hours but fewer transfusion requirements in CPB and hospitalization were demonstrated in the IG group (P< 0.05). For the children, the transfusion requirements in CPB and hospitalization of the CG group significantly decreased (P <0.05), while the postoperative chest tube drainage were compared between both groups (P>0.05). Multiple linear regression analysis indicated that age and bypass time were associated with postoperative chest tube drainage in infants and children.2. Compared to the IF group, the incidence of pulmonary infection and recovery time of the IG group significantly decreased (P<0.05), while the incidence of mortality and other morbidity were compared (P>0.05). For the children, the recovery time, incidence of mortality and morbidity were comparable between the CF and CG groups (P>0.05).ConclusionFor general pediatric patients undergoing elective cardiac surgery, it is feasible to substitute Gelofusine for FFP in CPB prime based on clinical guidelines.