Cardiopulmonary bypass without the use of donor blood components in heart surgery in an 8-kg infant: case report

The issue of rejecting donor blood components intraoperatively in children with congenital heart defects is widely discussed in the world literature. This is primarily due to the presence of a low volume of circulating blood, which leads to excessive hemodilution during artificial circulation. The purpose of this report is to demonstrate the safety and effectiveness of conducting operations associated with congenital heart defects without the use of transfusion of donor blood components. A case of surgical treatment of the interatrial septum defect in an 11-month (8 kg) infant with the use of cardiopulmonary bypass and a set of measures enabling to abandon transfusion media is presented. Retrograde filling of the oxygenator and maximum minimization of the extracorporeal circuit were used to reduce the primary volume. To ensure the required volume of blood in the cardiotomy tank, dosed vacuum was applied. Clinical and laboratory characteristics of the intraoperative and postoperative periods are given, which demonstrate sufficient oxygen supply of the organism, absence of anemia and any organ dysfunctions, as well as a low level of the systemic inflammatory response, once again confirming the immediate advantages of blood-saving technologies. Following the correction of congenital heart disease, the infant was transferred to a specialized surgical department on the second day. The outcome of the clinical case was the infant’s recovery and discharge from the hospital.