El uso de sangre fresca total en cardiopatías congénitas complejas


Autoria(s): Chalela Hernández, Tomás; Bresciani, Gino Renato; Carreño, Marisol; Hidalgo, Stella; Romero, Sandra Vanessa; Sandoval Reyes, Nestor Fernando
Contribuinte(s)

Sandoval Reyes, Nestor Fernando

Data(s)

28/08/2013

Resumo

Objetivos: Describir si el uso de sangre fresca total (SFT) intraoperatoria en pacientes llevados a procedimientos RACHS 3 y 4 en la Fundación Cardioinfantil, disminuye el sangrado postoperatorio y el volumen de transfusión de elementos sanguíneos, en comparación a aquellos en quienes no se usa SFT. Materiales y métodos: Se realizó un estudio de cohorte histórica, tomando una población menor de 1 año expuesta a la sangre fresca total y comparándola con una población de similares características, llevadas a procedimientos de riesgo similar no expuesta. Los análisis se realizaron mediante pruebas estándar para variables continuas y discretas. Un valor de p menor a 0.05 fue aceptado como signficativo. Resultados: 46 pacientes expuestos a SFT y se compararon con 50 pacientes no expuestos. La principal diferencia entre los grupos fue la edad, siendo mayor en el grupo de no expuestos (3.8 años vs 0.9; p<0.001). El volumen de sangrado postoperatorio fue similar, sin embargo los pacientes expuestos a SFT recibieron mayor volumen de transfusiones, sin ser una diferencia estadísticamente significativa (155cc vs 203cc, P=0.9). No hubo diferencia significativa en complicaciones o mortalidad. Conclusiones: En nuestro estudio no se encontró una disminución en el volumen de sangrado postoperatorio en los pacientes menores de 1 año, sometidos a cirugías catalogadas como RACHS 3 y 4, expuestos a SFT, sin embargo se necesitan estudios clínicos controlados que respondan definitivamente a la pregunta.

Introduction: The use of Fresh Whole Blood (FWB) has become a useful tool to lower postoperative bleeding in patients with complex congenital heart diseases, categorized as RACHS 3 and 4 procedures. The aim of this study is to evaluate the effectiveness of this procedure, in patients operated between 2007 and 2011 at Fundación Cardioinfantil. Materials and methods: We made a cohort study, taking a group of patients who receives FWB, and comparing it with another group of patients with similar characteristics and similar surgical procedures. Results: 46 patients who received FWB where compared to 50 controls that didn´t receive FWB. The main population difference was age. The non FWB group were older than the FWB group (3.8 años vs 0.9; p<0.001). The postoperative bleeding volume was similar between the two groups, but the FWB group received more transfusion volume, although it had no statistically significance (155cc vs 203cc, P=0.9). There was no difference in morbidity or mortality Conclusions: In our study we could not demonstrate a decrease in postoperative bleeding volume in patients less than one year, with RACHS 3 or 4 surgeries, who received FWB. More studies are needed to answer this question

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application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/4670

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/openAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

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Palavras-Chave #CARDIOPATÍAS CONGÉNITAS #CUIDADOS POSTOPERATORIOS #ENFERMEDADES CARDIOVASCULARES - CIRUGÍA #TRANSFUSIÓN SANGUÍNEA #Postoperative bleeding #Fresh whole blood
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion