Blood loss and transfusion practice in the perioperative management of craniosynostosis repair.

Abstract:

:During the past 5 years, the surgical repair for sagittal synostosis has been modified to a more complex and involved procedure. This led to a retrospective evaluation of the current transfusion practice in a large series of craniosynostosis repairs. The charts of 76 patients (81 surgical procedures) undergoing craniosynostosis repair from January 1990 to November 1996 were examined. The calculated volume of blood loss (BL) was determined for each surgical procedure and related to the estimated blood volume (EBV) and acceptable blood loss (ABL). The anesthesiologist's ability to estimate BL was compared with the calculated blood loss (CBL). In most surgical procedures for craniosynostosis, especially in the complex sagittal repairs, CBL was underestimated and exceeded ABL. Packed red blood cell transfusion occurred in 96.3% of the patients and was appropriate for most procedures based on ABL. Thus, transfusion for craniosynostosis repair is almost inevitable, and the preventive preparation of blood on the order of the mean estimated blood loss (EBL) plus 2 SD is appropriate. With the increased complexity of sagittal repair and its performance in a younger population, the cosmetic benefit of surgical repair has major implications for management of blood and fluids.

authors

Faberowski LW,Black S,Mickle JP

doi

10.1097/00008506-199907000-00002

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

167-72

issue

3

eissn

0898-4921

issn

1537-1921

journal_volume

11

pub_type

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