TITLE:
Intraoperative Goal-Directed Therapies in Femoral and Pelvic Osteotomies in Children and In-Hospital Postoperative Outcomes
AUTHORS:
Claudine Kumba, Mathilde Gaume, Arayik Barbarian, Zaga Péjin
KEYWORDS:
Femoral Osteotomy, Pelvic Osteotomy, Patient Blood Management, Fluid and Hemodynamic Goal-Directed Therapy, Children, Postoperative Outcome
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.11,
November
18,
2021
ABSTRACT: Background:Femoral and pelvic osteotomies are potential hemorrhagic interventions
where transfusion requirements can be necessary. Objective: We undertook
a secondary analysis of patients who underwent femoral and pelvic osteotomy in
the initial cohort. The objective of this secondary analysis was to describe
intraoperative and postoperative outcomes and to describe intraoperative
management in these patients in terms of blood product management and fluid and
hemodynamic therapy with the aim of implementing optimization management
protocols for postoperative outcome improvement. Methods: A secondary
analysis of patients who underwent femoral and pelvic osteotomy surgery was
included in the initial retrospective study. Results: There were
eighteen patients with a mean age of 104 ± 47.1 months. Four (22.2%) patients
had intraoperative and/or postoperative complications. One patient (5.6%) had an
intraoperative hemorrhagic shock, two patients (11.1%) had postoperative
neurologic failure, and one patient (5.6%) had postoperative wound sepsis. The
transfusion rate was 50% in nine patients. Conclusion: Femoral and
pelvic osteotomies are interventions where blood, transfusion and fluid
requirements can be increased; thus, this implies the necessity of a global
patient blood management protocol with point-of-care tests and fluid- and
hemodynamic-guided protocols with validated tools in children for
intraoperative and postoperative outcome optimization.