Abstract
Children with congenital heart disease undergoing surgical correction using cardiopulmonary bypass (CPB) had differences in pre- and post-operative thrombocytopenia. A chart review was performed to document these differences and identify etiologic factors in 40 consecutive patients admitted to a pediatric intensive care unit following corrective surgery for all types of congenital heart lesions. Eleven patients not on CPB had normal (mean 375,000/mm3) platelet counts and showed no intraoperative platelet loss or postoperative thrombocytopenia compared to 29 patients on CPB with transposition of the great vessels (TGV), Tetralogy of Fallot (TOF), ventricular septal defects (VSD), and atrial septal defects (ASD). Patients with TGV had lower pre-operative platelet counts compared to the group with TOF, VSD, and ASD (means 148,000/mm3 and 320,000/mm3 for the groups respectively). Intraoperative platelet loss was similar in the 4 groups (TGV, TOF, VSD, ASD). TGV patients had lower platelet counts on postoperative days 2-7 and the duration of thrombocytopenia (platelets <150,000/mm3) was prolonged, resolving by day 8, compared to those with TOF, VSD, and ASD who resolved by day 3. There was no difference in the duration of CPB among the groups. In this study, differences in preoperative platelet counts suggest marrow impairment as a factor in the failure of patients with TGV to respond to intraoperative platelet loss.
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Ducore, J., Schumacher, C., Mcgrath, R. et al. THROMBOCYTOPENIA IN CHILDREN WITH CONGENITAL HEART DISEASE UNDERGOING CORRECTIVE SURGERY USING CARDIO-PULMONARY BYPASS. Pediatr Res 11, 389 (1977). https://doi.org/10.1203/00006450-197704000-00120
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DOI: https://doi.org/10.1203/00006450-197704000-00120