J Pediatr Intensive Care 2022; 11(04): 308-315
DOI: 10.1055/s-0041-1725119
Original Article

Anemia after Pediatric Congenital Heart Surgery

Camille Jutras*
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHU Sainte-Justine, Montréal, Canada
Kim Anh La*
2   Research Center, CHU Sainte-Justine, Montréal, Canada
George Gerardis
2   Research Center, CHU Sainte-Justine, Montréal, Canada
Rachel Richard
2   Research Center, CHU Sainte-Justine, Montréal, Canada
1   Division of Pediatric Critical Care Medicine, Department of Pediatrics, CHU Sainte-Justine, Montréal, Canada
› Author Affiliations


The postoperative course of infants following congenital heart surgery is associated with significant blood loss and anemia. Optimal transfusion thresholds for cardiac surgery patients while in pediatric intensive care unit (PICU) remain a subject of debate. The goal of this study is to describe the epidemiology of anemia and the transfusion practices during the PICU stay of infants undergoing congenital heart surgery. A retrospective cohort study was performed in a PICU of a tertiary university-affiliated center. Infants undergoing surgery for congenital heart disease (CDH) before 6 weeks of age between February 2013 and June 2019 and who were subsequently admitted to the PICU were included. We identified 119 eligible patients. Mean age at surgery was 11 ± 7 days. Most common cardiac diagnoses were d-Transposition of the Great Arteries (55%), coarctation of the aorta (12.6%), and tetralogy of Fallot (11.8%). Mean hemoglobin level was 14.3 g/dL prior to surgery versus 12.1 g/dL at the PICU admission. Hemoglobin prior to surgery was systematically higher than hemoglobin at the PICU entry, except in infants with Hypoplastic Left Heart Syndrome. The average hemoglobin at PICU discharge was 11.7 ± 1.9 g/dL. Thirty-three (27.7%) patients were anemic at PICU discharge. Fifty-eight percent of patients received at least one red blood cell (RBC) transfusion during PICU stay. This study is the first to describe the epidemiology of anemia at PICU discharge in infants following cardiac surgery. Blood management of this distinctive and vulnerable population requires further investigation as anemia is a known risk factor for adverse neurodevelopment delays in otherwise healthy young children.

* These authors contributed equally to this work.

Publication History

Received: 05 November 2020

Accepted: 23 January 2021

Article published online:
23 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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