Effective management of acute hemorrhage using an SL One® rapid infusion device in a pediatric patient undergoing nephrectomy for Wilms tumor with inferior vena cava extension: a case report

TL;DR

A 2-year-old boy with a kidney tumor and blood vessel extension was successfully treated with a rapid infusion device during surgery to manage sudden bleeding.

Contribution

Demonstrates successful use of the SL One® rapid infusion device in a pediatric patient at high risk for acute hemorrhage.

Findings

The SL One® device enabled rapid transfusion at rates up to 150 mL/min during acute bleeding in a 2-year-old patient.

Hemodynamic stability was achieved without complications like hyperkalemia or hypothermia.

The postoperative recovery was uneventful, suggesting the device's safety in pediatric use.

Abstract

Wilms tumor is the most common pediatric renal tumor. Tumor extension into the inferior vena cava (IVC) can increase hemorrhage risk during surgical resection, necessitating rapid transfusion. Pediatric patients have lower circulating blood volume, heightening their susceptibility to hemodynamic instability.

A 2-year-old boy with an IVC-extending Wilms tumor underwent nephrectomy. Anticipating hemorrhage, we employed an SL One® rapid infusion device via a Broviac™ central venous catheter. During a sudden, high-volume bleeding, transfusion was initiated at 23 mL/min and intermittently increased to 150 mL/min while preload was evaluated using transesophageal echocardiography, rapidly stabilizing hemodynamics. No rapid-transfusion-related complications, such as hyperkalemia or hypothermia, were observed, and the postoperative course was uneventful.

In this pediatric case at high risk for acute blood loss, the SL One® provided effective circulatory stabilization without adverse events. Further studies are needed to validate the safety of the SL One® in pediatric patients.

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