Article ; Online: Epidemiology of severe bleeding in children following cardiac surgery involving cardiopulmonary bypass: use of Bleeding Assessment Scale for critically Ill Children (BASIC).
2022 Volume 33, Issue 10, Page(s) 1913–1919
Abstract: Objectives: To describe the epidemiology of severe bleeding in the immediate post-operative period in children who undergo cardiopulmonary bypass surgery using the Bleeding Assessment Scale for critically Ill Children (BASIC).: Study design: ... ...
| Abstract | Objectives: To describe the epidemiology of severe bleeding in the immediate post-operative period in children who undergo cardiopulmonary bypass surgery using the Bleeding Assessment Scale for critically Ill Children (BASIC). Study design: Retrospective cohort study in a paediatric ICU from 2015 to 2020. Results: 356 children were enrolled; 59% were male with median (IQR) age 2.1 (0.5-8) years. Fifty-seven patients (16%) had severe bleeding in the first 24 hours post-operatively. Severe bleeding was observed more frequently in younger and smaller children with longer bypass and cross-clamp times (p-values <0.001), in addition to higher surgical complexity (p = 0.048). Those with severe bleeding received significantly more red blood cells, platelets, plasma, and cryoprecipitate in the paediatric ICU following surgery (all p-values <0.001). No laboratory values obtained on paediatric ICU admission were able to predict severe post-operative bleeding. Those with severe bleeding had significantly less paediatric ICU-free days (p = 0.010) and mechanical ventilation-free days (p = 0.013) as compared to those without severe bleeding. Conclusions: Applying the BASIC definition to our cohort, severe bleeding occurred in 16% of children in the first day following cardiopulmonary bypass. Severe bleeding was associated with worse clinical outcomes. Standard laboratory assays do not predict bleeding warranting further study of available laboratory tests. |
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| MeSH term(s) | Humans ; Male ; Child ; Child, Preschool ; Female ; Retrospective Studies ; Cardiopulmonary Bypass/adverse effects ; Critical Illness ; Cardiac Surgical Procedures/adverse effects ; Postoperative Hemorrhage/epidemiology |
| Language | English |
| Publishing date | 2022-11-14 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 1078466-4 |
| ISSN | 1467-1107 ; 1047-9511 |
| ISSN (online) | 1467-1107 |
| ISSN | 1047-9511 |
| DOI | 10.1017/S1047951122003493 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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