Newly Published
Correspondence  |   May 2020
Priming Cardiopulmonary Bypass in Pediatric Surgery: Comment
Author Notes
  • Centre Hospitalier Universitaire Brugmann and Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium (D.S.). denis.schmartz@chu-brugmann.be
  • (Accepted for publication April 14, 2020.)
    (Accepted for publication April 14, 2020.)×
Article Information
Correspondence
Correspondence   |   May 2020
Priming Cardiopulmonary Bypass in Pediatric Surgery: Comment
Anesthesiology Newly Published on May 12, 2020. doi:https://doi.org/10.1097/ALN.0000000000003351
Anesthesiology Newly Published on May 12, 2020. doi:https://doi.org/10.1097/ALN.0000000000003351
We read with great interest the article of Dieu et al.1  regarding cardiopulmonary bypass (CPB) priming strategy in pediatric cardiac surgery. In this double-blind randomized controlled study, the authors reported that priming with fresh frozen plasma or balanced crystalloids does not result in a different risk of postoperative bleeding and transfusion of allogeneic blood components. The authors clearly have to be congratulated for addressing a very relevant clinical question in a study with a high level of methodologic quality. However, several points need to be taken into account when interpreting the reported results.
First, the studied population is probably not at a high risk of postoperative bleeding requiring the transfusion of hemostatic agents such as fresh frozen plasma. Indeed, most patients enrolled in the trial were small children (above 1 yr of age) undergoing low- to moderate-risk surgery (Risk Adjustment for Congenital Heart Surgery score, 1 to 3), whereas neonates and infants with cyanotic disease have been shown to be especially at higher risk of significant postoperative blood loss.2  The results of the present study do not help to define the best CPB priming strategy in these high-risk populations.