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, 9.51 ± 3.5 kg) and the blood loss from 0.7 to 7.1 g·kg-1 (4.6 ± 2.0 g·kg-1) The lowest values of the hematological findings in each case after surgery were as follows: Hb ranged from 7.6 to 10.9 g·dl-1 (8.8 ± 1.0 g·dl-1), blood platelet count from 158 X 103 to 337 x 103 cells·μ@?-1 (271 ± 88 x 103 cells·μ@?-1), and total protein from 4.3 to 5.5 g·dl-1 (5.0 ± 0.4 g·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.