Descriptive analysis of post-operative data.

<p>Descriptive analysis of post-operative data.</p

Influence of factor XIII activity on post-operative transfusion in congenital cardiac surgery—A retrospective analysis

<div><p>Objectives</p><p>Coagulation factor XIII (FXIII) plays a key role in fibrin clot stabilization—an essential process for wound healing following cardiothoracic surgery. However, FXIII deficiency as a risk for post-operative bleeding in pediatric cardiac surgery involving cardiopulmonary bypass (CPB) for congenital heart disease (CHD) is controversially discussed. Thus, as primary outcome measures, we analyzed the association of pre-operative FXIII activity and post-operative chest tube drainage (CTD) loss with transfusion requirements post-operatively. Secondary outcomes included the influence of cyanosis and sex on transfusion.</p><p>Methods</p><p>Our retrospective analysis (2009–2010) encompassed a single center series of 76 cardio-surgical cases with CPB (0–17 years, mean age 5.61 years) that were post-operatively admitted to our pediatric intensive care unit (PICU). The observational period was 48 hours after cardiac surgery. Blood cell counts and coagulation status, including FXIII activity were routinely performed pre- and post-operatively. The administered amount of blood products and volume expanders was recorded electronically, along with the amount of CTD loss. Uni- and multivariate logistic regression analysis was performed to calculate the associations (odds ratios) of variables with post-operative transfusion needs.</p><p>Results</p><p>FXIII activities remained stable following CPB surgery. There was no association of pre- and post-operative FXIII activities and transfusion of blood products or volume expanders in the first 48 hours after surgery. Similarly, FXIII showed no association with CTD loss. Cyanosis and female sex were associated with transfusion rates.</p><p>Conclusions</p><p>Although essentially involved in wound healing and clotting after surgery, FXIII activity does not serve as a valid predictor of post-operative transfusion need.</p></div

Analysis of the associations between intra-operative volume management and post-operative blood tests / transfusion requirements.

<p>Analysis of the associations between intra-operative volume management and post-operative blood tests / transfusion requirements.</p

Comparison of intra-operative volume management and oxygenator models.

<p>Comparison of intra-operative volume management and oxygenator models.</p

Multivariate logistic regression analysis of post-operative transfusion requirement.

<p>Multivariate logistic regression analysis of post-operative transfusion requirement.</p

Influence of factor XIII activity on post-operative transfusion in congenital cardiac surgery—A retrospective analysis - Fig 2

<p>A) Displayed is the number of patients (x-axis) per oxygenator model (y-axis), grouped according to the amount of CTD loss above (bright) or below (dark) the median. B) Comparison of the distribution of the complexity of cases (Aristotle score) among oxygenator models. Patients oxygenized with the D100 model had significantly higher Aristotle scores of 9.54 ± 2.76 (mean ± SD) when compared to patients on EVO and D101 (p<0.05 and p = 0.004, respectively). The mean Aristotle score of patients on EVO was 7.58 ± 2.09, while patients on D101 had the lowest scores 6.66 ± 2.23 (p<0.029 vs. EVO; p<0.004 vs. D100). Patients oxygenated on the D100 had the lowest BW with a median of 3.5 kg (range 2.3–4.6 kg) (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0199240#pone.0199240.s001" target="_blank">S1 Table</a>). * = p<0.05, ** = p<0.004.</p

Descriptive analysis of peri-operative data.

<p>Descriptive analysis of peri-operative data.</p

Univariate logistic regression analysis of post-operative transfusion requirement.

<p>Univariate logistic regression analysis of post-operative transfusion requirement.</p

Comparison of post-operative blood parameters of patients with chest tube drainage loss below/above the median.

<p>Comparison of post-operative blood parameters of patients with chest tube drainage loss below/above the median.</p

Overview of the primary (large font, grey background) and secondary measures (small font, white background) of our study.

<p>Abbreviations: preOP: pre-operatively, postOP: post-operatively, FXIII: factor XIII.</p