Hematocrit Levels, Blood Testing, and Blood Transfusion in Infants After Heart Surgery.

Objective: To determine whether judicious blood testing impacts timing or amount of packed RBC transfusions in infants after heart surgery. Design: A retrospective study comparing before and after initiation of a quality improvement process. Setting: A university-affiliated cardiac ICU at a tertiary care children's hospital. Patients: Infants less than 1 year old with Risk Adjustment for Congenital Heart Surgery category 4, 5, 6, or d-transposition of great arteries (Risk Adjustment for Congenital Heart Surgery 3) consecutively treated during 2010 through 2013. Intervention: A quality improvement process implemented in 2011 to decrease routine laboratory testing after surgery. Measurements and Main Results: Fifty-two infants preintervention and 214 postintervention had similar age, weight, proportion of cyanotic lesions, and surgical complexity. Infants with single versus biventricular physiology were compared separately. The number of laboratory tests per patient adjusted for cardiac ICU length of stay (laboratory tests/patient/day) was significantly lower in postintervention populations for single and biventricular groups (9 vs 15 and 10 vs 15, respectively; p

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