Babies who received the reconstituted blood during surgery to repair congenital heart defects on average had shorter stays in the intensive care unit and spent less time on mechanical ventilation after surgery than babies who received fresh whole blood blood that is less than 48 hours old and whose red cells and plasma have not been separated.
The findings, which appear in today's New England Journal of Medicine, put to rest a decades-long debate in the medical community, said Dr. Daniel Stromberg, assistant professor of pediatrics at UT Southwestern and the study's senior author.
"The results demonstrate that the current national opinion regarding the benefits of fresh whole blood is incorrect," said Dr. Stromberg, who is also a cardiologist at Children's. "Fresh whole blood priming of the cardiopulmonary bypass circuit is actually worse in terms of clinical outcomes. This is important for patients and for blood banks potentially saving lots of money and preserving component inventory."
During heart surgery, babies must be placed on a cardiopulmonary bypass machine, which does the work of the heart and lungs while surgeons make repairs. The machine must be primed with donor blood because babies do not have enough of their own blood to supply both the machine and their tiny bodies. Blood priming of the cardiopulmonary bypass machine is not necessary for adults, whose blood volume is larger.
Traditionally, surgeons have insisted on using fresh whole blood to prime the bypass machine and would even cancel procedures when it wasn't available. Using reconstituted blood would ease blood centers'
Contact: Staishy Bostick Siem
UT Southwestern Medical Center