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Bloodless Pediatric Cardiac Surgery? Deliverance with Erythropoietin

Division of Critical Care Medicine 1 Division of Cardiovascular Surgery 2 Division of Cardiology 3 Division of Anesthesia The Hospital for Sick Children and University of Toronto, Faculty of Medicine Toronto, Canada

For reprint information contact: Michael D Black, MD Division of Cardiovascular Surgery (Rm 1525) The Hospital for Sick Children 555 University Avenue Toronto M5G 1X8, Canada Tel: 1 416 813 6418 Fax: 1 416 813 7984 Email: michael.black{at}mailhub.sickkids.on.ca

A 2-year-old 11.6 kg boy with congenital heart disease whose parents refused homologous blood products was treated preoperatively with iron and human recombinant erythropoietin for 6 weeks. Surgical repair was performed without exposure to blood products other than human albumin. Treatment with iron and erythropoietin in combination with post-bypass modified ultrafiltration, minimization of hemodilution, reinfusion of residual pump prime, and diuresis may reduce or avoid the need for blood transfusion in acyanotic children undergoing elective cardiac surgery.