A trial of fresh autologous whole blood to treat dilutional coagulopathy following cardiopulmonary bypass in infants

Friesen, Robert H.; Perryman, Kathy M.; Weigers, K; Mitchell, Max B.; Friesen, Richard M.

doi:10.1111/j.1460-9592.2005.01805.x

Cited by 33 publications

(21 citation statements)

References 28 publications

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“…However, if cardiac bypass was used, additional disturbance of the coagulation system, such as platelet dysfunction, excessive fibrinolysis and consumption of coagulation factors, might aggravate dilution following administration of the priming volume [40]. Thus, coagulation testing and management should be adapted to the type of surgery.…”

Section: Management Of Dilutional Coagulopathy In Childrenmentioning

confidence: 99%

Management of Dilutional Coagulopathy during Pediatric Major Surgery

Haas¹,

Mauch²,

Weiß³

et al. 2012

Transfus Med Hemother

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Perioperative dilutional coagulopathy is a major coagulation disorder during adult and pediatric surgery. Although the main underlying mechanisms are comparable, data of the development and management of dilutional coagulopathy in children are scarce. Observational data showed that intraoperative coagulation disorders mainly based on complex disturbances of clot firmness including acquired fibrinogen as well as factor XIII deficiencies, while clotting time and platelet counts remained fairly stable. A fast and reliable monitoring of the entire coagulation process (e.g. thrombelastometry) might be of extreme value for detection and guidance of effective coagulation management. Although the transfusion of fresh frozen plasma was recommended in several guidelines, the use of coagulation factors might offer an alternative and potentially superior approach in managing perioperative coagulation disorders. Further studies are urgently needed to determine the efficacy of modern coagulation management.

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Section: Management Of Dilutional Coagulopathy In Childrenmentioning

confidence: 99%

Management of Dilutional Coagulopathy during Pediatric Major Surgery

Haas¹,

Mauch²,

Weiß³

et al. 2012

Transfus Med Hemother

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show abstract

“…Naguib et al assessed the use of ANH as part of a comprehensive strategy to minimize blood transfusion, but not as an isolated technique . In a prospective RCT, Friesen et al collected 15 mL/kg of fresh autologous whole blood prior to heparin administration, using a normovolemic technique, from children weighing 5‐12 kg undergoing CPB . They hypothesized that retransfusion of the autologous blood after CPB would result in an improved coagulation status in study patients.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of autologous intraoperative blood collection and retransfusion in small children with complex congenital heart defects undergoing cardiopulmonary bypass

Kaiser

Miller

Tian

et al. 2018

Pediatric Anesthesia

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The use of autologous intraoperative blood collection and retransfusion is a feasible option for small children with complex congenital heart defects undergoing cardiopulmonary bypass. Study patients received significantly fewer donor exposures without an increase in postoperative bleeding. Children who require multiple cardiac surgeries or eventually transplantation could benefit from this blood conservation technique.

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“…However, if a cardiac bypass were used, additional disturbance to the coagulation system, such as platelet dysfunction, excessive fi brinolysis, or consumption of coagulation factors might aggravate dilution following administration of the priming volume (Friesen et al 2006 ). Thus, coagulation testing and management should be adapted to the type of surgery.…”

Section: Preoperative Considerationsmentioning

confidence: 99%