Intraoperative Red Blood Cell Transfusion in Infant Heart Transplant Patients Is Not Associated with Worsened Outcomes.


BACKGROUND:Red blood cell (RBC) transfusion is common during infant cardiac surgery. A previous report of pediatric heart transplant recipients showed that increased RBC transfusion volume was independently associated with increased length of intensive care unit stay. It is unclear whether transfusion to infants as a subgroup carries similar risks. This study investigated relationships between intraoperative RBC transfusion during heart transplantation and postoperative length of stay (LOS), morbidity, and mortality in infants. METHODS:Retrospective analysis of medical records from infants <1 year old undergoing primary heart transplantation at Loma Linda University Medical Center from 1985 to 2012 was conducted. Exclusion criteria included preoperative exchange transfusion or extracorporeal membrane oxygenation. Data sought included patient characteristics; intraoperative RBC transfusion volume and cardiopulmonary bypass details; and postoperative vasoactive support, ventilator support, morbidity, LOS, and 30-day mortality. The relationship of RBC transfusion volume (mL/kg) to these postoperative variables was assessed by univariate analysis. Multiple regression analysis of postoperative LOS included variables that were independent predictors of LOS or associated with ≥10% change in the β-estimate for RBC effect. RESULTS:Data from 307 infants showed that most (66.8%) had single-ventricle physiology. Median age at transplant was 50 days, weight 3.95 kg, and intraoperative transfusion volume 109 mL/kg. Transfusion volume was inversely related to age and weight. Median postoperative LOS was 18.2 days. Univariate linear regression analysis of transfused volume showed no relationship to log-transformed postoperative LOS (F(1,305) = 0.00; P = 0.960; R = 0.000; β-coefficient = 0.004; 95% confidence interval = -0.1542 to 0.1623). Transfused volume was not related to 30-day mortality (difference -0.162; -0.048 to 0.371 mL/kg; P = 0.112) or to postoperative ventilator support (R = 0.047), but was greater in patients who required reoperation (difference -0.246; -0.494 to -0.025; P = 0.004). Multiple regression analysis for all patients revealed age, preoperative ventilator support, prolonged postoperative ventilatory or vasoactive support, transplant year, and 30-day mortality, but not major adverse events, to be significant confounding variables. Adjusting for these variables, transfused volume was not associated with prolonged postoperative LOS. CONCLUSIONS:In contrast to a prior report, we found no correlation between intraoperative RBC transfusion and postoperative LOS when studying only infants. Infants have maturing organ systems, less physiologic reserve, and increased surgical blood loss (evaluated as mL/kg) during cardiac surgery than their larger, older counterparts, distinguishing them from the general pediatric population. These differences require additional studies to determine the outcome impact of transfusion strategies in the infant subgroup.


Anesth Analg


Anesthesia and analgesia


Carter HF,Lau C,Juma D,Wells B,Applegate RL 2nd




Has Abstract


2016-05-01 00:00:00














  • Sorptive loss of volatile and gaseous anesthetics from in vitro drug application systems.

    abstract::In in vitro pharmacological experiments, determination of effective concentration values for various anesthetics depends on understanding the exact concentration of the drugs dissolved in physiological solutions. Actual anesthetic concentration may differ from expectations because of drug adsorption, absorption or oth...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Suzuki T,Uchida I,Mashimo T

    更新日期:2005-02-01 00:00:00

  • Age and the spread of local anesthetic solutions in the epidural space.

    abstract::Sensory level of anesthesia following the injection of 20 ml of 1.5% lidocaine with epinephrine (1:200,000) in 238 adult males averaged T7.7, T5.6, and T5.1 at 10, 20, and 30 minutes, respectively. Patient age had no significant effect on local anesthetic requirements per spinal segment per unit height until age 40 ye...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Park WY,Massengale M,Kim SI,Poon KC,Macnamara TE

    更新日期:1980-10-01 00:00:00

  • A comparison of the volume and pH of gastric contents of obese and lean surgical patients.

    abstract:UNLABELLED:Obese surgical patients are typically considered to be more likely than lean patients to possess high-volume and low-pH (HVLP) gastric contents after a standard preoperative fast, based on a study of a population predominately consisting of patients receiving intramuscular preoperative sedation. We revisited...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Harter RL,Kelly WB,Kramer MG,Perez CE,Dzwonczyk RR

    更新日期:1998-01-01 00:00:00

  • Epidural ropivacaine anesthesia decreases the bispectral index during the awake phase and sevoflurane general anesthesia.

    abstract::The sedative effects of epidural anesthesia without volatile and IV anesthetics and quantification of the degree of epidural anesthesia-induced sedation have not been investigated. In the current study we evaluated the effects of epidural anesthesia on the bispectral index (BIS) during the awake phase and during gener...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Ishiyama T,Kashimoto S,Oguchi T,Yamaguchi T,Okuyama K,Kumazawa T

    更新日期:2005-03-01 00:00:00

  • S(+)-ketamine as an analgesic adjunct reduces opioid consumption after cardiac surgery.

    abstract::There are no studies evaluating S(+)-ketamine for pain management after sternotomy. In this prospective, randomized, double-blind, placebo-controlled clinical trial, we evaluated the efficacy and feasibility of S(+)-ketamine as an adjunctive analgesic after cardiac surgery. Ninety patients scheduled for elective coron...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lahtinen P,Kokki H,Hakala T,Hynynen M

    更新日期:2004-11-01 00:00:00

  • Does arginine vasopressin influence the coagulation system in advanced vasodilatory shock with severe multiorgan dysfunction syndrome?

    abstract::Arginine vasopressin (AVP) is a potent supplementary vasopressor in advanced vasodilatory shock, but decreases in platelet count have been reported during AVP therapy. In this study we evaluated the effects of AVP infusion on the coagulation system in advanced vasodilatory shock when compared to norepinephrine (NE) in...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Dünser MW,Fries DR,Schobersberger W,Ulmer H,Wenzel V,Friesenecker B,Hasibeder WR,Mayr AJ

    更新日期:2004-07-01 00:00:00

  • Posterior tibial nerve sensory blockade duration prolonged by adding dexmedetomidine to ropivacaine.

    abstract:BACKGROUND:Dexmedetomidine, an α(2)-receptor agonist, prolongs analgesia when used in neuraxial and IV blocks. We evaluated the effect of dexmedetomidine added to ropivacaine for tibial nerve block on the duration of the sensory blockade. METHODS:For this prospective, randomized, controlled, double-blind, crossover tr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Rancourt MP,Albert NT,Côté M,Létourneau DR,Bernard PM

    更新日期:2012-10-01 00:00:00

  • A Methyltransferase Inhibitor (Decitabine) Alleviates Intergenerational Effects of Paternal Neonatal Exposure to Anesthesia With Sevoflurane.

    abstract:BACKGROUND:Neonatal exposure to sevoflurane induces neurobehavioral and neuroendocrine abnormalities in exposed male rats (generation F0) and neurobehavioral, but not neuroendocrine, abnormalities in their male, but not female, offspring (generation F1). These effects of sevoflurane are accompanied by a hypermethylated...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Xu N,Lei L,Lin Y,Ju LS,Morey TE,Gravenstein N,Yang J,Martynyuk AE

    更新日期:2020-10-01 00:00:00

  • Postoperative intravenous morphine consumption, pain scores, and side effects with perioperative oral controlled-release oxycodone after lumbar discectomy.

    abstract:BACKGROUND:Oral opioid formulations contribute to postoperative analgesia. In this study, we evaluated the perioperative application of oral controlled-release oxycodone to reduce postoperative IV morphine consumption and opioid side effects after lumbar discectomy. METHODS:Forty patients scheduled for elective lumbar...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验


    authors: Blumenthal S,Min K,Marquardt M,Borgeat A

    更新日期:2007-07-01 00:00:00

  • A comparison of oral clonidine and oral midazolam as preanesthetic medications in the pediatric tonsillectomy patient.

    abstract:UNLABELLED:We compared the effects of oral clonidine (4 microg/kg) and midazolam (0.5 mg/kg) on the preanesthetic sedation and postoperative recovery profile in children during tonsillectomy with or without adenoidectomy. In a double-blinded, double-dummy study design, 134 ASA physical status I-II children aged 4-12 yr...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fazi L,Jantzen EC,Rose JB,Kurth CD,Watcha MF

    更新日期:2001-01-01 00:00:00

  • A cryogenic machine for selective recovery of xenon from breathing system waste gases.

    abstract:BACKGROUND:Xenon has many characteristics that make it very attractive as an anesthetic and therapeutic drug. Unfortunately, the supply of xenon is fixed, and therefore reclamation and recovery from even the most efficient breathing circuits is desirable. We built and evaluated a cryogenic device to recover xenon from ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Dingley J,Mason RS

    更新日期:2007-11-01 00:00:00

  • Anesthesia as therapy for persistent hiccups.

    abstract:IMPLICATIONS:Chronic hiccups may be a serious therapeutic problem. Pharmacological treatment with increasing dosages of baclofen, carbamazepine, or gabapentin is not always successful. In this paper, the use of general anesthesia with positive-pressure ventilation and muscle relaxation for the termination of chronic hi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Lierz P,Felleiter P

    更新日期:2002-08-01 00:00:00

  • Intravenous verapamil blunts hyperdynamic responses during electroconvulsive therapy without altering seizure activity.

    abstract:IMPLICATIONS:A dose of 0.1 mg/kg of verapamil, administered immediately before anesthesia, significantly reduces the increase in peak heart rate and mean arterial blood pressure after electroconvulsive therapy. Furthermore, the administration of verapamil does not reduce the duration of the seizure. ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Wajima Z,Yoshikawa T,Ogura A,Imanaga K,Shiga T,Inoue T,Ogawa R

    更新日期:2002-08-01 00:00:00

  • Pharmacokinetics of lidocaine in nonpregnant and pregnant ewes.

    abstract::The pharmacokinetics of lidocaine were studied in nonpregnant and pregnant ewes. The maternal femoral vessels were cannulated and, on the day of study, the urinary bladder was catheterized. Lidocaine HCl, 4-5 mg/kg, was administered by IV injection over 60 seconds. Serial samples of arterial blood and urine were colle...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Santos AC,Pedersen H,Morishima HO,Finster M,Arthur GR,Covino BG

    更新日期:1988-12-01 00:00:00

  • Sciatic cryoneurolysis in rats: a model of sympathetically independent pain. Part 1: Effects of sympathectomy.

    abstract::The purpose of this study was to evaluate the effects of preemptive and postlesion sympathectomy in the sciatic cryoneurolysis (SCN) model of neuropathic pain in rats. SCN in rats produces a prolonged significant mechanical allodynia (hypersensitivity to previously non-noxious mechanical stimuli) with no thermal hyper...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Willenbring S,Beauprie IG,DeLeo JA

    更新日期:1995-09-01 00:00:00

  • Comparison of kinetics of sevoflurane and isoflurane in humans.

    abstract::The low solubility of sevoflurane in blood suggests that this agent should enter and leave the body more rapidly than isoflurane. However, the closeness of sevoflurane and isoflurane tissue/blood partition coefficients suggests that the rates of equilibration with and elimination from tissues should be similar. We tes...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Yasuda N,Lockhart SH,Eger EI 2nd,Weiskopf RB,Liu J,Laster M,Taheri S,Peterson NA

    更新日期:1991-03-01 00:00:00

  • A single adrenocorticotropic hormone stimulation test does not reveal adrenal insufficiency in septic shock.

    abstract::The diagnosis of adrenocortical insufficiency in critically ill patients is complex. The adrenocorticotropic hormone (ACTH) stimulation test is a widely accepted method for assessing the adequacy of adrenal function in intensive care units, but it is possible that there may be wide variations in responses to the test ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Loisa P,Uusaro A,Ruokonen E

    更新日期:2005-12-01 00:00:00

  • Evaluating the long-term retention of a multidisciplinary electroencephalography instructional model.

    abstract:BACKGROUND:Clinical decision making and problem solving require a core of basic factual knowledge that must be accessed sometimes months or years after it has been learned. We examined whether 10 compared with 20 total electroencephalogram (EEG) interpretations impacted scores for long-term retention with the residents...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Fahy BG,Chau DF,Ozrazgat-Baslanti T,Owen MB

    更新日期:2014-03-01 00:00:00

  • A comparison of general anesthesia and lumbar epidural analgesia for elective cesarean section.

    abstract::Controversy exists concerning the choice of anesthetic technic for elective cesarean section. Several maternal and newborn parameters were compared during general anesthesia (GA) and lumbar epidural analgesia (LEA). High inspired maternal O2 levels were achieved with both technics. Vigorous, well-oxygenated infants wi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: James FM 3rd,Crawford JS,Hopkinson R,Davies P,Naiem H

    更新日期:1977-03-01 00:00:00

  • The impact of oral premedication with midazolam on respiratory function in children.

    abstract:BACKGROUND:Premedication with midazolam is commonly used in children to reduce anxiety and improve cooperation before anesthesia. However, it has the potential to alter respiratory function because of its muscle relaxant properties. We assessed functional residual capacity (FRC), ventilation homogeneity, using a lung c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: von Ungern-Sternberg BS,Erb TO,Habre W,Sly PD,Hantos Z

    更新日期:2009-06-01 00:00:00

  • Promoting a Restrictive Intraoperative Transfusion Strategy: The Influence of a Transfusion Guideline and a Novel Software Tool.

    abstract:BACKGROUND:The effect of neither transfusion guidelines nor decision support tools on intraoperative transfusion has been previously evaluated. The University of Michigan introduced a transfusion guideline in 2009, and in 2011, the Department of Anesthesiology developed a transfusion decision support tool. The primary ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Picton P,Starr J,Kheterpal S,Thompson AML,Housey M,Sathishkumar S,Dubovoy T,Kirkpatrick N,Tremper KK,Engoren M,Ramachandran SK

    更新日期:2018-09-01 00:00:00

  • An absorbable local anesthetic matrix provides several days of functional sciatic nerve blockade.

    abstract:BACKGROUND:Functional blockade of peripheral nerves is the primary objective of local anesthesia, and it is often desirable to have a persistent blockade, sustained throughout and beyond a surgical procedure. Current local anesthetics give effective analgesia for <8-12 h after a single bolus injection. We report on an ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Wang CF,Djalali AG,Gandhi A,Knaack D,De Girolami U,Strichartz G,Gerner P

    更新日期:2009-03-01 00:00:00

  • A comparison between meperidine, clonidine and urapidil in the treatment of postanesthetic shivering.

    abstract:UNLABELLED:Postanesthetic shivering can be treated with many types of drugs. We compared the effects of meperidine, clonidine, and urapidil on postanesthetic shivering. Sixty patients shivering during recovery from general anesthesia were treated in a randomized, double-blinded fashion with 25 mg meperidine IV, 0.15 mg...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schwarzkopf KR,Hoff H,Hartmann M,Fritz HG

    更新日期:2001-01-01 00:00:00

  • Glymphatic System Function in Relation to Anesthesia and Sleep States.

    abstract::The brain is one of the most metabolically active organs in the body. The brain's high energy demand associated with wakefulness persists during rapid eye movement sleep, and even during non-rapid eye movement sleep, cerebral oxygen consumption is only reduced by 20%. The active bioenergetic state parallels metabolic ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Benveniste H,Heerdt PM,Fontes M,Rothman DL,Volkow ND

    更新日期:2019-04-01 00:00:00

  • Anatomical landmarks for femoral nerve block: a comparison of four needle insertion sites.

    abstract:UNLABELLED:The site for needle insertion in femoral nerve block varies significantly among various descriptions of the technique. To determine the site with the highest likelihood of needle-femoral nerve contact, femoral nerve block was simulated in a human cadaver model (17 femoral triangles from 9 adult cadavers). Fo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Vloka JD,Hadzić A,Drobnik L,Ernest A,Reiss W,Thys DM

    更新日期:1999-12-01 00:00:00

  • Intraneural recording of muscle sympathetic activity during epidural anesthesia in humans.

    abstract::The extent and magnitude of sympathetic blockade during epidural anesthesia have previously been assessed only by indirect methods. In this study, direct intraneural recordings of muscle sympathetic activity (MSA) in the peroneal nerve was performed to determine the profundity of blockade of sympathetic fibers to the ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Lundin S,Wallin BG,Elam M

    更新日期:1989-12-01 00:00:00

  • The effects of olprinone (a phosphodiesterase III inhibitor) on hepatic vascular bed in a porcine model of endotoxemia.

    abstract:UNLABELLED:Decreased hepatic blood flow, and impaired hepatic oxygen delivery caused by endotoxin, result in hepatic metabolic deterioration followed by liver dysfunction and multiple organ failure. Among phosphodiesterase III inhibitors, only olprinone increases hepatosplanchnic blood flow. We evaluated the effects of...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Nagata E,Kakihana Y,Tobo K,Isowaki S,Kanmura Y

    更新日期:2001-03-01 00:00:00

  • Surgical stress induces endotoxin hyporesponsiveness and an early decrease of monocyte mCD14 and HLA-DR expression during surgery.

    abstract:UNLABELLED:It is generally accepted that major surgery is associated with severe alterations of the host-defense mechanisms. We investigated the effect of surgical stress on the immune system. Specifically, we studied the relationship between perioperative lipopolysaccharide (LPS) hyporesponsiveness and monocyte human ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Kawasaki T,Ogata M,Kawasaki C,Tomihisa T,Okamoto K,Shigematsu A

    更新日期:2001-05-01 00:00:00

  • Buffered Solutions Versus Isotonic Saline for Resuscitation in Nonsurgical Critically Ill: Protocol for Cochrane Review.

    abstract::Fluid resuscitation is one of the most prevalent treatment in critical care. There is not definitive evidence about the best fluid for resuscitation. The aim of this review will be to asses the efficacy and safety of buffered solution versus saline. We will perform an electronic search in Medline, Embase, and Central....

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审


    authors: Barea-Mendoza JA,Antequera AM,Plana MN,Chico-Fernández M,Muriel A,Sáez I,Estrada-Lorenzo JM,Montejo-González JC

    更新日期:2016-12-01 00:00:00

  • In vitro anesthetic washin and washout via bubble oxygenators: influence of anesthetic solubility and rates of carrier gas inflow and pump blood flow.

    abstract::The uptake and elimination of volatile anesthetic agents administered to patients under conditions of hemodilution and hypothermia during cardiopulmonary bypass have not been determined. To define the limitations imposed by oxygenators, we defined washin and washout curves for volatile anesthetic agents administered t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Nussmeier NA,Moskowitz GJ,Weiskopf RB,Cohen NH,Fisher DM,Eger EI 2nd

    更新日期:1988-10-01 00:00:00