Open-heart surgery without homologous blood transfusion in infants and children under simple deep hypothermia.

PURPOSE: To investigate the hematological changes during the perioperative period of open-heart surgery without homologous blood transfusion under simple deep hypothermia in infants and small children, and to define the limits of body weight for open-heart surgery without homologous blood transfusion under simple deep hypothermia.

METHODS: We performed open-heart surgery without homologous blood transfusion under simple deep hypothermia on eight children, four infants, and a neonate with diagnoses of atrial septal defect, ventricular septal defect, on total anomalous pulmonary venous return (TATVR). All patients except for one with TAPVR were surface-cooled with ice water under deep ether anesthesia. Hematological examinations were performed seven times during the perioperative period.

RESULTS: The body weight of the patients ranged from 2.5 to 15.0 kg (mean±SD, 9.5±3.5 kg) and the blood loss from 0.7 to 7.1g·kg(-1) (4.6±2.0g·kg(-1)) The lowest values of the hematological findings in each case after surgery were as follows: Hb ranged from 7.6 to 10.9g·dl(-1) (8.8±1.0g·dl(-1)), blood platelet count from 158×10(3) to 337×10(3) cells·µℓ(-1)-agonist (271±88 ×10(3) cells·µℓ(-1)-agonist, and total protein from 4.3 to 5.5 g·dl(-1) (5.0±0.4g·dl(-1)) CONCLUSION: Severe anemia and hypoproteinemia were not detected in any case, and, in particular, the reduction of the platelet count was slight. No events occurred as a result of decreased Hb concentration, serum protein, or both.