Issue |
J Extra Corpor Technol
Volume 46, Number 2, June 2014
|
|
---|---|---|
Page(s) | 173 - 176 | |
DOI | https://doi.org/10.1051/ject/201446173 | |
Published online | 15 June 2014 |
Case Reports
Bloodless Pediatric Cardiopulmonary Bypass for a 3.2-kg Patient Whose Parents are of Jehovah’s Witness Faith
* The Heart Center at Nationwide Children’s Hospital, Columbus, Ohio
† Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio
‡ Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio
Address correspondence to: Todd M. Ratliff, BS, CCP, Perfusionist, Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205. E-mail: Todd.Ratliff@nationwidechildrens.org
Received:
24
March
2014
Accepted:
30
May
2014
Patients and parents of Jehovah’s Witness (JW) faith present multiple challenges to a medical team, especially in the neonatal and pediatric population. The medical team must balance honoring the parents’ request of not receiving blood products and fulfilling our commitment as advocates for the child’s wellbeing. A multidisciplinary approach to cardiac surgery must be embraced for bloodless cardiopulmonary bypass (CPB) to be successful. At our institution, we have developed strategies and techniques for blood conservation that are used preoperatively, intraoperatively, and postoperatively for every CPB case with the goal of a bloodless procedure. These protocols include: preoperative erythropoietin, preoperative iron administration, selection of a CPB circuit specific to the patient’s height and weight, acute normovolemic hemodilution, retrograde autologous prime and venous autologous prime, tranexamic acid administration, zerobalance ultrafiltration, flushing of the pump suckers post-CPB, modified ultrafiltration, and cell salvage. We present an 8-day-old, 3.2-kg patient of JW faith with aortic valve stenosis and regurgitation and a patent foramen ovale who underwent a bloodless left ventricle-to-aorta tunnel repair and aortic valve repair on CPB.
Key words: Jehovah’s Witness / bloodless / pediatric cardiopulmonary bypass
© 2014 AMSECT
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