TITLE:
Patient Blood Management in Craniosynostosis Surgery
AUTHORS:
Claudine Kumba
KEYWORDS:
Craniosynostosis, Children, Transfusion, Outcome, Point of Care Viscoelastic Assays, Rotational Thromboelastometry
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.11 No.4,
September
10,
2021
ABSTRACT: Background: Craniosynostosis surgery is one of the most hemorrhagic interventions,
where transfusion rates vary from 20% to
100% depending on the study. Objective: To describe intraoperative and
postoperative outcomes in a secondary analysis of children who underwent
craniosynostosis surgery included in the initial retrospective study with the
aim of proposing intraoperative implementation optimization protocols for
postoperative outcome improvement. Methods: Secondary analysis. The
study was approved by the Ethics Committee. Results: There were 69 children with a median age of 10 [0 - 207] months. Eight (11.6%) patients had intraoperative and/or postoperative
complications. One patient (1.5%) had intraoperative hemorrhagic shock, and two
patients (2.9%) had intraoperative broncholaryngospasm. One patient (1.5%) had
postoperative anaphylaxis. One patient (1.5%) had postoperative hemorrhagic
shock. One patient (1.5%) had postoperative respiratory failure. Two patients
(2.9%) had postoperative neurologic failure. One patient (1.5%) had neuro-meningeal
sepsis. One patient (1.5%) had a re-operation. There was no in-hospital
mortality. Fourty-eight patients (69.6%) had intraoperative transfusions. Conclusion: Transfusion protocols guided with point-of-care tests should be included in
patient blood management programs in craniosynostosis surgery.