Blood products for paediatric patients in congenital heart surgery: A retrospective, single- centre study

Introduction: Blood transfusions during paediatric cardiac surgery with (cardiopulmonary bypass) CPB carry increased risks, including infection and immunological complications. This study evaluates blood product use in the Clinic for Paediatric Cardiology and Cardiac Surgery at the Children’s University Hospital following the implementation of a revised blood management protocol from 2020 to 2023. Methods: A retrospective review of 135 paediatric patients who underwent congenital cardiac surgery with CPB was conducted. Patients were categorized into three age groups: Group 1 (<1 year), Group 2 (1 – 4 years), and Group 3 (>4 years). Data on erythrocyte, fresh frozen plasma (FFP), cryoprecipitate, and platelet use were analysed using the Kruskal-Wallis and Spearman’s rho tests, with significance set at p <.05, and confidence interval (CI) of 95% quoted when applicable. Results: Erythrocyte use significantly declined over 4 years, with the largest reductions observed from 2020 to 2023 [p <.0001]. Older and heavier patients required fewer transfusions, with a significant inverse correlation between weight and erythrocyte use [Spearman’s rho = −0.29, p =.001]. Platelet use also decreased significantly from 2020 to 2023 [p =.04], while FFP and cryoprecipitate use declined notably over the same period [p < 0.01]. Conclusion: Over 4 years, significant reductions in blood product use were observed, particularly for erythrocytes and platelets. Patients’ age and weight were inversely related to erythrocyte transfusion needs. These trends may reflect improvements in surgical techniques and blood management protocols, with potential benefits for patient outcomes.