AbstractThis paper presents a summary and analysis of the journal article titled ‘Cardiopulmonary Bypass Priming Using Autologous Cord Blood in Neonatal Congenital Cardiac Surgery’ as published in the Korean Circulation Journal. This summary and analysis will provide a brief overview of the article’s content. The discussion will involve several sections including sample selection, research methodology and design, data collection, results, and overall comments on the article.

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Summary
In the article, the authors set out to investigate whether the use of autologous cord blood was feasible as a primer in cardiopulmonary bypass for neonates as compared to allo-transfusion. The participants in the study were twenty neonates awaiting surgery for congenital heart disease from whom cord blood was drawn and stored for future transfusion, although only 8 of the neonates were transfused with cord blood1(pp.715). Of the eight neonates transfused with autologous cord blood, seven did not require allo-transfusion thus showing that autologous cord blood was a feasible alternative in CPB priming to reduce allo-transfusion during congenital heart surgery.

Sample
The participants selected initially for this study were twenty neonates with a pre-diagnosis for congenital heart disease requiring cardiac surgery. These participants were selected non-randomly using purposive sampling, in which the authors selected subjects specifically from the target group based on their own judgment. While the initial sample size comprised of (n=20) neonates, 12 of the blood samples were spoiled and the final sample size was (n=8) neonates1 (pp.715).

Type of Study
This research was a prospective study as it sought to track outcomes such as development of complications after using autologous cord blood in cardiac surgery for neonates, while also relating these outcomes to factors including suspected risk2(pp.24). Further, the study was confidential in nature since it was still possible to link or identify data from specific subjects to the particular participant. In terms of research approach, the study adopted a quantitative research method by generating numerical data which was then converted into statistics for use in determining the feasibility of using autologous cord blood in neonatal congenital cardiac surgery, as well as generalizing the results from a bigger population sample. As an experimental quantitative study, the research sought to determine the cause-effect association among study variables while imposing control over other variables that are not of interest. The independent variable was autologous cord blood transfusion, while the dependent variable was requirement for allo-transfusion1 (pp.715). The study did not identify any confounding variables.

How was the research conducted?
In gathering information, the researchers used the arterial blood gas analysis test to measure oxygen and carbon-dioxide levels in the blood with the aim of determining whether allo-transfusion was required1(715). Another instrument used in the study was the serology blood test to measure antibody levels, which helped determine whether the autologous cord blood transfusion introduced bacterial infections into the neonates’ bodies. The instruments were valid since the authors reported that their results agreed with previous studies demonstrating feasibility of cord-blood collection for transfusions. The instruments were also reliable since seven out of the eight participant neonates produced similar and consistent results after transfusion with autologous cord blood1 (716).

Results
The statistical method used for analysis of data involved descriptive statistics, which were utilized to summarize collected data from the participant samples through properties including dispersion and central tendency2 (pp.39). The only measure of central tendency used in the study was median, in which the researchers described the median body weight and age of the neonates, median hematocrit and amount of cord blood collected, median preoperative neonate hematocrit, and the median CPB priming volume. There was no description of standard deviation in the results. These results could be considered significant since they reveal that gentle cord blood drawing techniques and timely application of CPB protocol enable the safe use of autologous cord blood in for CPB priming1(pp.717). The only obvious error of measurement was the limited amount of cord blood, while the small sample size (n=8) can be considered as a source of statistical bias.

Discussion
This study is an excellent resource for healthcare professionals dealing with neonates who require cardiac surgery, although it does have a major limitation in terms of the simplicity of its study design and the small sample size. Future studies could research the longer-term effect of neonatal transfusions with autologous blood using a larger sample size.

    References
  • Choi, E.S., Cho, S., Jang, W.S. and Kim, W.H., Cardiopulmonary Bypass Priming Using Autologous Cord Blood in Neonatal Congenital Cardiac Surgery. 2016, Korean Circulation Journal 46(5), 714-718
  • Vogt, W. P. Sage Quantitative Research Methods. 2011, London: SAGE, 2011.