Pediatric patients are undergoing open-heart surgery using cardiopulmonary bypass (CPB) exhibit hemodilution, hemolysis, and post-operative anemia at the termination of the CPB.
ABT includes three options: preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), and intraoperative and postoperative autotransfusion.
(11) All the adverse effects of CPB in pregnancy such as hemodilution, changes in coagulation, complement activation, release of vasoactive substances by leukocytes and particulates, air embolization, and hypotension further add to the deleterious effect of myxomas on the respiratory system and cause hypoxia and early uterine contraction.
The lower than expected rise in Hgb following 2 units could be explained by ongoing hemolysis related to sickling as evidence by a reticulocyte event of 14% hemodilution secondary to fluid overload which may also have had a part.