Clinical Assessment of Severe Hemolysis in a 15-Month-Old Infant With Tetralogy of Fallot Undergoing Surgical Repair During Cardiopulmonary Bypass: A Case Report



Ziyaeifard M¹ ; Farasatkish R² ; Alizadehasl A¹ ; Goudarzi M³ ; Jamalian J² Show Affiliations
Source: Iranian Heart Journal Published:2022

Abstract

Some degrees of hemolysis are probable in pediatric patients receiving cardiopulmonary bypass. Nonetheless, severe hemolysis, even in premature infants undergoing cardiac surgeries, is rare. When hemolysis happens in a neonate or infant receiving cardiopulmonary bypass, numerous causes, including erythrocyte membrane defects, hemoglobinopathies, iso-immunization, undiagnosed enzyme abnormalities, and acquired conditions such as sepsis or drug interactions, should be considered. Urine discoloration may be considered a hemolytic reaction secondary to blood transfusion; still, in mild degrees of hemolysis due to mechanical trauma, this discoloration may not be noticed. One type of acute hemolytic reaction is immunological, which may happen secondary to the interaction between the recipient’s antibodies and the donor’s antigens, although most severe cases of hemolytic anemia are secondary to ABO incompatibility In this case report, we describe a 15-month-old infant undergoing surgical repair for tetralogy of Fallot, who developed hemolysis during cardiopulmonary bypass. We also discuss the case’s diagnostic workup and therapeutic management. © 2022, Iranian Heart Association. All rights reserved.