Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient

Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of extra-corporeal technology 2020-06, Vol.52 (2), p.142-145
Hauptverfasser: Burnside, Jeffrey L., Ratliff, Todd M., Kelly, Madeleine N., Naguib, Aymen N., Galantowicz, Mark, Hodge, Ashley
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 145
container_issue 2
container_start_page 142
container_title The Journal of extra-corporeal technology
container_volume 52
creator Burnside, Jeffrey L.
Ratliff, Todd M.
Kelly, Madeleine N.
Naguib, Aymen N.
Galantowicz, Mark
Hodge, Ashley
description Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of allogeneic blood products. Patients of families of the Jehovah’s Witness (JW) faith reject the use of these products because of religious beliefs. Our institution is a referral center for children of JW families because we have developed techniques to minimize blood loss with the hope of performing bloodless pediatric cardiac surgery whenever possible. These techniques include preoperative treatment with erythropoietin, intraoperative acute normovolemic hemodilution, CPB circuit miniaturization, ultrafiltration during and after CPB, limiting blood gas analyses or other unnecessary blood draws, and using hemostatic agents during and after CPB. We present the case of a 4-day-old patient of the JW faith weighing 2.7 kg with transposition of the great arteries and an intact ventricular septum who underwent an arterial switch operation. The patient received no allogeneic blood product administration throughout the entire hospitalization. The patient’s first hematocrit in the OR was 43%, lowest hematocrit on bypass was 15%, and first hematocrit in the cardiothoracic intensive care unit post-procedure was 21%. The patient was discharged on post-op day nine with a hematocrit of 36%.
doi_str_mv 10.1051/ject/202052142
format Article
fullrecord <record><control><sourceid>crossref</sourceid><recordid>TN_cdi_crossref_primary_10_1051_ject_202052142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>10_1051_ject_202052142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1942-5e0caf7feb41daf8b46143838ed8f797990e68083a4fcc58c7ced1358602e8113</originalsourceid><addsrcrecordid>eNo9kEtOwzAURS0EEqUwZewNOH3Pzscelop_pSIBYhi5zjNJCUllRyBmbIPtsRIagRjdyblncBg7RUgQMpxtyA0zCRIyiancYxNpciO0yWGfTQCkFDtMH7KjGDcAOYLCCbs9a_u-ailGPg8Dhca2_P69GVzNV1sKdmj6jjcdt1wmhXh55jdU92-2_v78ivypGbrxebfDqBuO2YG3baSTv52yx4vzh8WVWK4urxfzpXBoUikyAmd94WmdYmW9Xqc5pkorTZX2hSmMAco1aGVT71ymXeGoQpXpHCRpRDVlya_XhT7GQL7chubVho8SoRxTlGOK8j-F-gFZxFI_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient</title><source>Open Access: PubMed Central</source><source>EZB Electronic Journals Library</source><creator>Burnside, Jeffrey L. ; Ratliff, Todd M. ; Kelly, Madeleine N. ; Naguib, Aymen N. ; Galantowicz, Mark ; Hodge, Ashley</creator><creatorcontrib>Burnside, Jeffrey L. ; Ratliff, Todd M. ; Kelly, Madeleine N. ; Naguib, Aymen N. ; Galantowicz, Mark ; Hodge, Ashley</creatorcontrib><description>Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of allogeneic blood products. Patients of families of the Jehovah’s Witness (JW) faith reject the use of these products because of religious beliefs. Our institution is a referral center for children of JW families because we have developed techniques to minimize blood loss with the hope of performing bloodless pediatric cardiac surgery whenever possible. These techniques include preoperative treatment with erythropoietin, intraoperative acute normovolemic hemodilution, CPB circuit miniaturization, ultrafiltration during and after CPB, limiting blood gas analyses or other unnecessary blood draws, and using hemostatic agents during and after CPB. We present the case of a 4-day-old patient of the JW faith weighing 2.7 kg with transposition of the great arteries and an intact ventricular septum who underwent an arterial switch operation. The patient received no allogeneic blood product administration throughout the entire hospitalization. The patient’s first hematocrit in the OR was 43%, lowest hematocrit on bypass was 15%, and first hematocrit in the cardiothoracic intensive care unit post-procedure was 21%. The patient was discharged on post-op day nine with a hematocrit of 36%.</description><identifier>ISSN: 0022-1058</identifier><identifier>EISSN: 2969-8960</identifier><identifier>DOI: 10.1051/ject/202052142</identifier><language>eng</language><ispartof>The Journal of extra-corporeal technology, 2020-06, Vol.52 (2), p.142-145</ispartof><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1942-5e0caf7feb41daf8b46143838ed8f797990e68083a4fcc58c7ced1358602e8113</citedby><cites>FETCH-LOGICAL-c1942-5e0caf7feb41daf8b46143838ed8f797990e68083a4fcc58c7ced1358602e8113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids></links><search><creatorcontrib>Burnside, Jeffrey L.</creatorcontrib><creatorcontrib>Ratliff, Todd M.</creatorcontrib><creatorcontrib>Kelly, Madeleine N.</creatorcontrib><creatorcontrib>Naguib, Aymen N.</creatorcontrib><creatorcontrib>Galantowicz, Mark</creatorcontrib><creatorcontrib>Hodge, Ashley</creatorcontrib><title>Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient</title><title>The Journal of extra-corporeal technology</title><description>Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of allogeneic blood products. Patients of families of the Jehovah’s Witness (JW) faith reject the use of these products because of religious beliefs. Our institution is a referral center for children of JW families because we have developed techniques to minimize blood loss with the hope of performing bloodless pediatric cardiac surgery whenever possible. These techniques include preoperative treatment with erythropoietin, intraoperative acute normovolemic hemodilution, CPB circuit miniaturization, ultrafiltration during and after CPB, limiting blood gas analyses or other unnecessary blood draws, and using hemostatic agents during and after CPB. We present the case of a 4-day-old patient of the JW faith weighing 2.7 kg with transposition of the great arteries and an intact ventricular septum who underwent an arterial switch operation. The patient received no allogeneic blood product administration throughout the entire hospitalization. The patient’s first hematocrit in the OR was 43%, lowest hematocrit on bypass was 15%, and first hematocrit in the cardiothoracic intensive care unit post-procedure was 21%. The patient was discharged on post-op day nine with a hematocrit of 36%.</description><issn>0022-1058</issn><issn>2969-8960</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNo9kEtOwzAURS0EEqUwZewNOH3Pzscelop_pSIBYhi5zjNJCUllRyBmbIPtsRIagRjdyblncBg7RUgQMpxtyA0zCRIyiancYxNpciO0yWGfTQCkFDtMH7KjGDcAOYLCCbs9a_u-ailGPg8Dhca2_P69GVzNV1sKdmj6jjcdt1wmhXh55jdU92-2_v78ivypGbrxebfDqBuO2YG3baSTv52yx4vzh8WVWK4urxfzpXBoUikyAmd94WmdYmW9Xqc5pkorTZX2hSmMAco1aGVT71ymXeGoQpXpHCRpRDVlya_XhT7GQL7chubVho8SoRxTlGOK8j-F-gFZxFI_</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Burnside, Jeffrey L.</creator><creator>Ratliff, Todd M.</creator><creator>Kelly, Madeleine N.</creator><creator>Naguib, Aymen N.</creator><creator>Galantowicz, Mark</creator><creator>Hodge, Ashley</creator><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>202006</creationdate><title>Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient</title><author>Burnside, Jeffrey L. ; Ratliff, Todd M. ; Kelly, Madeleine N. ; Naguib, Aymen N. ; Galantowicz, Mark ; Hodge, Ashley</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1942-5e0caf7feb41daf8b46143838ed8f797990e68083a4fcc58c7ced1358602e8113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Burnside, Jeffrey L.</creatorcontrib><creatorcontrib>Ratliff, Todd M.</creatorcontrib><creatorcontrib>Kelly, Madeleine N.</creatorcontrib><creatorcontrib>Naguib, Aymen N.</creatorcontrib><creatorcontrib>Galantowicz, Mark</creatorcontrib><creatorcontrib>Hodge, Ashley</creatorcontrib><collection>CrossRef</collection><jtitle>The Journal of extra-corporeal technology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burnside, Jeffrey L.</au><au>Ratliff, Todd M.</au><au>Kelly, Madeleine N.</au><au>Naguib, Aymen N.</au><au>Galantowicz, Mark</au><au>Hodge, Ashley</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient</atitle><jtitle>The Journal of extra-corporeal technology</jtitle><date>2020-06</date><risdate>2020</risdate><volume>52</volume><issue>2</issue><spage>142</spage><epage>145</epage><pages>142-145</pages><issn>0022-1058</issn><eissn>2969-8960</eissn><abstract>Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of allogeneic blood products. Patients of families of the Jehovah’s Witness (JW) faith reject the use of these products because of religious beliefs. Our institution is a referral center for children of JW families because we have developed techniques to minimize blood loss with the hope of performing bloodless pediatric cardiac surgery whenever possible. These techniques include preoperative treatment with erythropoietin, intraoperative acute normovolemic hemodilution, CPB circuit miniaturization, ultrafiltration during and after CPB, limiting blood gas analyses or other unnecessary blood draws, and using hemostatic agents during and after CPB. We present the case of a 4-day-old patient of the JW faith weighing 2.7 kg with transposition of the great arteries and an intact ventricular septum who underwent an arterial switch operation. The patient received no allogeneic blood product administration throughout the entire hospitalization. The patient’s first hematocrit in the OR was 43%, lowest hematocrit on bypass was 15%, and first hematocrit in the cardiothoracic intensive care unit post-procedure was 21%. The patient was discharged on post-op day nine with a hematocrit of 36%.</abstract><doi>10.1051/ject/202052142</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-1058
ispartof The Journal of extra-corporeal technology, 2020-06, Vol.52 (2), p.142-145
issn 0022-1058
2969-8960
language eng
recordid cdi_crossref_primary_10_1051_ject_202052142
source Open Access: PubMed Central; EZB Electronic Journals Library
title Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T18%3A47%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-crossref&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Bloodless%20Arterial%20Switch%20Operation%20in%20a%202.7-kg%20Jehovah%E2%80%99s%20Witness%20Patient&rft.jtitle=The%20Journal%20of%20extra-corporeal%20technology&rft.au=Burnside,%20Jeffrey%20L.&rft.date=2020-06&rft.volume=52&rft.issue=2&rft.spage=142&rft.epage=145&rft.pages=142-145&rft.issn=0022-1058&rft.eissn=2969-8960&rft_id=info:doi/10.1051/ject/202052142&rft_dat=%3Ccrossref%3E10_1051_ject_202052142%3C/crossref%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true