Bloodless Protocols in Pediatrics Do Not Change Clinical Outcomes

Background: Parents may request bloodless surgery and medical care for their children. However, parents’ wishes may be changed by court orders when clinicians deem transfusion to be necessary. There are ethical dilemmas for both clinicians and parents. Objective: To analyze benefits and ethical considerations surrounding patients whose parents had requested bloodless care. Design: Single-center, retrospective cohort study. Methods: Patients aged Results: 196 patients were included in the bloodless group for analysis. No significant difference was noted between groups with regard to transfusion, which was 9.1% in the standard group and 6.1% in the bloodless group. No court orders were issued for transfusion in the bloodless group. Composite morbidity was significantly higher in the standard group (6.2%) compared to the bloodless group (2.6%; P =0.035). No significant differences were found in any other secondary outcomes between groups. No mortality occurred in the bloodless gro more...