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Journal of Current Pediatric Research | Volume: 23
March 14-15, 2019 | London, UK
International Conference on
Pediatrics & Neonatal Healthcare
Transfusion and postoperative outcome in Pediatric Abdominal Surgery: Is transfusion a morbidity
factor in Pediatric Abdominal surgical patients?
Claudine Kumba, Querciagrossa S, Blanc T
and
Tréluyer JM
Necker Sick Children’s University Hospital, France
Background:
Intraoperative and postoperative Morbi-mortality
factors are multiple in pediatric patients. Studies in pediatric
cardiac surgery and intensive care patients have identified
transfusion as one independent factor among others. This study
was undertaken to investigate whether transfusion was an
independent factor of Morbi-mortality in pediatric abdominal
surgical patients.
Objectives:
To identify Morbi-mortality risk factors in
intraoperatively transfused and not transfused pediatric
abdominal surgical patients.
Design:
Retrospective observational descriptive pediatric
cohort study.
Setting:
Monocentric pediatric tertiary center, Necker Enfants
Malades University Hospital Paris, from 1 January 2014 to 17
Mai 2017.
Patients:
193 patients with a median age of 27.5 months [1.0-
100.5] were included. Inclusion criteria were the presence
or the absence of transfusion in the intraoperative period in
abdominal surgery patients. Exclusion criterion was transfusion
in the postoperative period until discharge from Hospital and
non-abdominal surgical patients.
Main outcome measures:
Primary outcome was mortality
and secondary outcome was morbidity in transfused and
non-transfused patients. Mortality was assessed by deaths
occurring intraoperatively or postoperatively during the entire
hospitalization. Morbidity was assessed by intraoperative,
postoperative complications, repeat surgery, length of stay in
the intensive care unit, in the hospitalization ward, total length
of stay in hospital and length of mechanical ventilation.
Results:
Transfusion was the independent predictive risk factor
for postoperative complications (odds ratio 1.14; p-value 0.02)
and an independent predictive risk factor for repeat surgery
(odds ratio 1.11; p-value 0.01). Emergency surgery was an
independent predictive risk factor for repeat surgery (odds ratio
5.63; p-value 0.01). Transfusion, age, emergency surgery and
ASA score status were independent predictive risk factors for
length of stay in the intensive care unit, total length of hospital
stay and length of mechanical ventilation (p-value<0.01).
Conclusion:
Transfusion was identified as an independent
morbidity risk factor among others in this pediatric population.
Identifying these factors in order to implement improvement
measures can upgrade patient postoperative outcome. One of
these measures is to implement transfusion protocols in which
blood product administration is guided by point of care devices
such as viscoelastic methods which can contribute to reduce
transfusion intraoperatively in potential hemorrhagic surgical
interventions.
Speaker Biography
ClaudineKumbagraduatedasaMedicalDoctor in2001andcompletedherspecialization
in Anesthesiology in 2006 at the Free University of Brussels (ULB, Université Libre de
Bruxelles). She has a Paediatric Anaesthesia specialisation graduation since 2010 from
the University of Aix- Marseille, Marseille, France. She has a Critical Care Medicine
specialization graduation since 2014 from the University of Montpellier 1, Montpellier,
France. She is a paediatric anaesthesiologist in Necker Sick Children’s University
Hospital in Paris, France. She has 12 publications and 17 citations. She is a member
of the European Society of Paediatric Anaesthesiology (ESPA), the French Society of
Anaesthesia and Critical Care (SFAR, Société Française d’Anesthésie-Réanimation) and
the French Association for Paediatric Anaesthesiolgists and Intensivists) (ADARPEF,
Association d’Anesthésistes et Réanimateurs Pédiatriques d’Expression Française) and
the Belgian Association for Paediatric Anaesthesiology (BAPA).
e:
Claudine.kumba@gmail.comNotes:
Claudine Kumba et al., Curr Pediatr Res, Volume 23
DOI: 10.4066/0971-9032-C1-011