Autologous hemodonation in the corrective surgery of craniostenosis

Longatti, Pierluigi; Paccagnella, F.; Agostini, S.; Nieri, A; Carteri, A

doi:10.1007/bf00263832

Cited by 34 publications

(28 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Erythrocyte transfusion is associated with many serious adverse events, including increased mortality in the pediatric surgical population. 5 Numerous techniques intended to reduce intraoperative blood loss during craniosynostosis surgery have been studied, including autologous blood predonation, 6 short-term normovolemic hemodilution, 7 and intraoperative blood salvage. 3,8 Most of these techniques reported disappointing results, with relatively low benefits in terms of transfusion requirements.…”

mentioning

confidence: 99%

Intraoperative Tranexamic Acid Reduces Blood Transfusion in Children Undergoing Craniosynostosis Surgery

Dadure¹,

Sauter²,

Bringuier³

et al. 2011

Anesthesiology

212

183

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Intraoperative Tranexamic Acid Reduces Blood Transfusion in Children Undergoing Craniosynostosis Surgery

Dadure¹,

Sauter²,

Bringuier³

et al. 2011

Anesthesiology

212

183

View full text Add to dashboard Cite

show abstract

“…PAD in pediatric patients weighing 6.7 kg or more has been reported. 25,29 In fact, it has been performed in cardiac lesion patients as young as 3 years of age and weighing as little as 12.7 kg. 6 An average volume phlebotomized can range from 10 to 20% 29 of circulating blood volume or to a reported maximum of 19 mL/kg.…”

Section: Preoperative Autologous Donationmentioning

confidence: 99%

“…31 Light narcosis can be induced with oral midazolam administered 30 minutes prior to the procedure. 29 This strategy is efficacious for patients who have alloantibodies or rare blood types and for those who refuse homologous blood transfusion. The cost, timing and risk of donation, 32 patient size and circulating blood volume as well as the logistics of getting to and from the donation site are all factors that must be considered.…”

Section: Preoperative Autologous Donationmentioning

confidence: 99%

See 1 more Smart Citation

Blood Conservation During Pediatric Cardiac Surgery

Gómez

Olshove

Weinstein

et al. 2002

Transfus Alt Transfus Med

View full text Add to dashboard Cite

1 Blood conservation techniques in adult and pediatric cardiac surgery have evolved over the past 50 years. Congenital cardiac surgical repair with CPB has induced up to a 300% hemodilutional effect.2,3 In the 1960s, disposable CPB equipment was developed and non-heme primes were utilized to reduce transfusion exposure. 4,5Today, the first question many parents ask is not "Is my child fine?" but "Did my child receive any blood?" The public's perception of banked blood being tainted has prompted surgeons to limit or eliminate blood transfusions. Autologous donation has helped reduce the need for homologous transfusion. In pediatrics, however, this technique is limited by kilogram weight.6 Indeed, weight loss and preoperative anemia have been found to be highly significant predictors for the need of red blood cell transfusion and postoperative morbidity. 7-12Cardiopulmonary bypass causes a total body inflammatory response and dilution of coagulation factors, a phenomenon which exacerbates postoperative bleeding. Preoperative treatment of anemia and coagulation imbalances has reduced blood transfusions. 13 The use of antifibrinolytics has changed transfusion patterns due to reduced postoperative bleeding. Cell salvaging systems have become commonplace in the operating room and intensive care unit. Modified ultrafiltration, commonly used in pediatrics, has been effective in increasing hematocrit (Hct) levels, concentrating patient plasma volume, and reducing the body's inflammatory response to cardiopulmonary bypass.

show abstract

“…24,35 One study had a transfusion rate of 36% after ANH during craniosynostosis corrections. 21 One study found no reduction in transfusion rates or amounts with ANH. 15 Aly Hassan found that ANH was well tolerated in the pediatric population without measurable signs of anaerobic metabolism.…”

mentioning

confidence: 98%

Minimizing transfusion requirements for children undergoing craniosynostosis repair: the CHoR protocol

Vega¹,

Lyon²,

Kierce³

et al. 2014

PED

View full text Add to dashboard Cite

Object Children with craniosynostosis may require cranial vault remodeling to prevent or relieve elevated intracranial pressure and to correct the underlying craniofacial abnormalities. The procedure is typically associated with significant blood loss and high transfusion rates. The risks associated with transfusions are well documented and include transmission of infectious agents, bacterial contamination, acute hemolytic reactions, transfusion-related lung injury, and transfusion-related immune modulation. This study presents the Children's Hospital of Richmond (CHoR) protocol, which was developed to reduce the rate of blood transfusion in infants undergoing primary craniosynostosis repair. Methods A retrospective chart review of pediatric patients treated between January 2003 and Febuary 2012 was performed. The CHoR protocol was instituted in November 2008, with the following 3 components; 1) the use of preoperative erythropoietin and iron therapy, 2) the use of an intraoperative blood recycling device, and 3) acceptance of a lower level of hemoglobin as a trigger for transfusion (< 7 g/dl). Patients who underwent surgery prior to the protocol implementation served as controls. Results A total of 60 children were included in the study, 32 of whom were treated with the CHoR protocol. The control (C) and protocol (P) groups were comparable with respect to patient age (7 vs 8.4 months, p = 0.145). Recombinant erythropoietin effectively raised the mean preoperative hemoglobin level in the P group (12 vs 9.7 g/dl, p < 0.001). Although adoption of more aggressive surgical vault remodeling in 2008 resulted in a higher estimated blood loss (212 vs 114.5 ml, p = 0.004) and length of surgery (4 vs 2.8 hours, p < 0.001), transfusion was performed in significantly fewer cases in the P group (56% vs 96%, p < 0.001). The mean length of stay in the hospital was shorter for the P group (2.6 vs 3.4 days, p < 0.001). Conclusions A protocol that includes preoperative administration of recombinant erythropoietin, intraoperative autologous blood recycling, and accepting a lower transfusion trigger significantly decreased transfusion utilization (p < 0.001). A decreased length of stay (p < 0.001) was seen, although the authors did not investigate whether composite transfusion complication reductions led to better outcomes.

show abstract

Autologous hemodonation in the corrective surgery of craniostenosis

Cited by 34 publications

References 5 publications

Intraoperative Tranexamic Acid Reduces Blood Transfusion in Children Undergoing Craniosynostosis Surgery

Intraoperative Tranexamic Acid Reduces Blood Transfusion in Children Undergoing Craniosynostosis Surgery

Blood Conservation During Pediatric Cardiac Surgery

Minimizing transfusion requirements for children undergoing craniosynostosis repair: the CHoR protocol

Contact Info

Product

Resources

About