Children undergoing cardiopulmonary bypass suffer
disproportionate adverse effects because of their size and
immature hematopoietic system. Postoperative bleeding is
exacerbated by hemodilution, induction of a systemic
inflammatory response, along with platelet and coagulation
factor activation and depletion. Effective management of
bleeding after cardiopulmonary bypass in children requires
that physicians understand and are familiar with every
technique available to balance competing needs of minimizing
blood loss and transfusion, while maintaining good
perfusion so that a child’s perioperative and long-term
outcome is optimized.