Iranian Heart Journal

Iranian Heart Journal

Association of Hemoglobin Concentrations With Clinical Outcomes and Serum Lactate Concentrations After Open-Heart Surgery in Acyanotic Pediatric Patients

Document Type : Original Article

Authors
Amirhossein Jalali 1
Mostafa Mirzaei 2
Reza Golpira 3
Yousef Moghadam 3
Mohsen Ziyaeifard 1
1 Congenital Heart Disease Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
2 Cardiovascular Nursing Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
3 Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Abstract
Background: In children, the discrepancy between the cardiopulmonary bypass (CPB) circuit size relative to body size is greater than that in adults. However, hemoglobin and hematocrit levels during and after CPB may lead to hemodynamic and electrolyte disturbances.
 
Methods: This retrospective, descriptive-analytic study included 441 pediatric patients (weight: 5–15 kg) with congenital heart defects who underwent cardiac surgery and met the eligibility criteria. The association between groups with hemoglobin concentrations of 8 to 10 g/dL and greater than 10 g/dL was assessed. Arterial blood samples, recorded every 12 hours for up to 72 hours of ICU admission after open-heart surgery, were entered into the data collection form.
 
Results: The groups showed significant differences in mean age, weight, height, and body surface area, as well as the frequency distribution of sex. The independent samples t test demonstrated that mean lactate concentration (P = 0.014), urinary output (P = 0.001), diastolic blood pressure (P = 0.013), systolic blood pressure (P > 0.001), intubation time (P = 0.003), and mean arterial pressure (P > 0.001) were significantly higher in Group 2 (hemoglobin ≥10 g/dL) than in Group 1 (hemoglobin 8–10 g/dL).
 
Conclusions: In acyanotic pediatric patients with low hemoglobin, mean lactate concentration, urinary output, intubation time, and mean arterial pressure were lower, and these patients received greater blood and blood product transfusions compared with patients with high hemoglobin. (Iranian Heart Journal 2026; 27(1): 71-80)
Keywords
clinical outcomes
acyanotic congenital pediatric patients
hemoglobin concentrations
open-heart surgery in pediatrics
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Iranian Heart Journal
Volume 27, Issue 1
Winter 2026
Pages 71-80