Paediatric cardiac & thoracic surgery and cardiology ordering schedule for blood & blood products

exp date isn't null, but text field is

Objectives

A protocol for the transfusion requirements for paediatric cardiac, thoracic and cardiology patients undergoing a procedure. 

Scope

Neonates, infants and children undergoing a cardiac, thoracic or cardiology procedure.

Audience

Medical and nursing staff in areas managing cardiac, thoracic and cardiology patients in the Royal Hospital for Children, Glasgow

This schedule indicates which Blood Bank requests should be made for patients before cardiac and thoracic surgical or cardiology procedures. All patients should have a minimum of group and save. For cross‐matches, the schedule states how much of each product should be ordered. In an emergency, 2 units of Group O Negative blood are available in the Theatre blood fridge. Fully cross‐matched blood can be available in 45 minutes from receipt of sample.


Please inform Blood Bank (ext 80393 or page 8039 out-of-hours) if you have a cross-match request after 3pm for blood required the next day.

Red Cell Concentrate

Platelets, Fresh Frozen Plasma & Cryoprecipitate

Some patients undergoing cardiopulmonary bypass require blood products to be available for theatre. These should be ordered on Trakcare. Enter the date of surgery. Products will be requested by theatre when required.

Procedure

Number of Units

Open cardiac case

(cardiopulmonary bypass)

3

Re-do Cardiopulmonary Bypass
Norwood stage 1
RV-PA conduit

4

Closed cardiac case

1

Removal of sternal wire
Insertion of pleural drain

Gp&S

Cardiac Catheterisation:
diagnostic or interventional

Gp&S

Empyema drainage

Major thoracic surgery

1

≥1 (ask surgeon)

Irradiated & CMV negative Components

Request irradiated RCC for patients with Di George syndrome or those with chromosome analysis results outstanding (see Genetic Investigation Pathway for Infants with Congenital Heart Disease).

A special requirements form must be completed and sent to Blood Bank

Changes to theatre scheduling

The Cardio-thoracic registrar should contact Blood Bank in the event of cases being re-scheduled: blood components may need to be reserved for longer or the order cancelled allowing blood to be used elsewhere.

List of procedures

Open Cardiac Cases (Cardiopulmonary Bypass)

Aortic valve surgery
Atrial Septal Defect closure
Atrio-ventricular Septal Defect repair
Bidirectional Glenn procedure
Interrupted aortic arch repair
Left Ventricular Outflow Tract resection
Mitral valve surgery
Norwood procedure stage 1
Pulmonary Artery surgery
Pulmonary Valve surgery
Rastelli procedure
RV-PA conduit construction
Tetralogy of Fallot repair
Transposition of the Great Arteries for arterial switch
Truncus Arteriosus repair
Total Anomalous Pulmonary Venous Drainage repair
Total Cavo-Pulmonary Connection
Ventricular Septal Defect

Closed Cardiac Cases

Blalock Taussig shunt
Coarctation of Aorta (if planned with left heart assist, treat as open case)
Defibrillator insertion
Pacemaker insertion
Patent Ductus Arteriosus – surgical ligation
Pulmonary Artery banding
Vascular Ring

Thoracic Cases

Congenital Lung Cyst excision
Lobectomy
Lung decortication

Note: This list of procedures is not exhaustive. If in doubt, please discuss with the surgical or anaesthetic team.

Editorial Information

Last reviewed: 01 April 2014

Next review: 01 April 2016

Author(s): Anne Goldie & Elaine Harrison