Blood Loss Estimation During Fronto-Orbital Advancement

Seruya, Mitchel; Oh, Albert K.; Rogers, Gary F.; Han, Kevin; Boyajian, Michael J.; Myseros, John S.; Yaun, Amanda L.; Keating, Robert F.

doi:10.1097/scs.0b013e31825bd02a

Cited by 24 publications

(5 citation statements)

References 14 publications

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“…Our blood product transfusion strategy defined above has been successful. Intraoperative RBC and FFP transfusion levels were found to be similar to the results of other studies [5,15], and we did not encounter long-duration hypotension episodes or serious CVP declines. In CVP and Hct values obtained immediately after the operation for evaluation, no volume overload or excessive blood transfusion was found.…”

Section: Discussionsupporting

confidence: 78%

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Factors Influencing Blood Loss and Postoperative Morbidity in Children Undergoing Craniosynostosis Surgery: A Retrospective Study

Ali¹,

Başaran²,

Yornuk³

et al. 2013

Pediatr Neurosurg

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Background: Craniosynostosis is a condition resulting from the premature fusion of cranial sutures. Corrective surgery is often associated with a large amount of blood loss, with transfusion of red blood cells (RBC) and fresh frozen plasma (FFP). The aims of this study were to determine the variables associated with increased blood loss and postoperative complications. Methods: A retrospective analysis was performed of 42 pediatric patients who underwent craniosynostosis surgery. We analyzed the following: demographic parameters, duration of surgery, intraoperative blood loss, RBC, FFP and fluid transfusion, urine output, and hemodynamic parameters. In addition, we recorded the postoperative length of stay in the intensive care unit and hospital, postoperative blood loss and early complications. Results: The mean age, weight and surgical duration were 9.2 ± 3.2 months, 9.3 ± 2.0 kg and 255.8 ± 46.7 min, respectively. Intraoperative blood loss was 61.2 ± 15.3 ml/kg and RBC, FFP and fluid transfusion were 27.3 ± 7.1 ml/kg, 16.5 ± 4.7 ml/kg and 21.7 ± 4.6 ml/kg/h, respectively. Greater intraoperative blood loss was associated with longer surgical duration (p = 0.001, correlation coefficient = 0.495, R² = 0.245) and lower patient weight (p < 0.001, correlation coefficient = -0.557, R² = 0.311). Longer hospital stay was associated with greater intraoperative blood loss (p < 0.001, correlation coefficient = 0.754, R² = 0.568) and greater intraoperative RBC transfusion (p < 0.001, correlation coefficient = 0.795, R² = 0.632). Conclusion: Severe blood loss occurred in all children who underwent craniosynostotic corrections. Furthermore, the duration of surgery, patient weight and certain surgical procedures correlated with greater blood loss. Careful hemodynamic monitoring and evaluation of a patient's hematocrit value and volume status together may be helpful in maintaining the balance between insufficient and excessive blood product transfusion.

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Section: Discussionsupporting

confidence: 78%

“…It is very hard to predict the amount of blood loss in all types of cranial surgeries [10]. Unfortunately, there are no universally accepted guidelines for blood loss determination [15]. We used the method of calculated blood loss.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Blood Loss and Postoperative Morbidity in Children Undergoing Craniosynostosis Surgery: A Retrospective Study

Ali¹,

Başaran²,

Yornuk³

et al. 2013

Pediatr Neurosurg

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show abstract

“…The authors have reported blood losses greater than 500 mL for craniosynostosis patients, with means around 300 mL. 15 , 17 , 20 – 22 Our DGA demonstrates lower means and similar blood loss ranges. Furthermore, the DGA transfusion requirements fell within or below current literature values.…”

Section: Discussionmentioning

confidence: 68%

The Directive Growth Approach for Nonsyndromic, Unicoronal Craniosynostosis: Patient and Clinical Outcomes

Mann

Fahrenkopf

Burton

et al. 2017

Journal of Craniofacial Surgery

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Deformities of the cranium in patients with nonsyndromic single-suture synostosis occur because of growth restriction at fused sutures and growth over compensation at normal sutures. Traditional surgery includes ostectomies of the synostotic suture to release these restricted areas and osteotomies to enable immediate cranial remodeling. In the process of reshaping the cranium, traditional approaches usually involve obliteration of both the normal functioning suture and the pathologic suture. The directive growth approach (DGA) is a new, simpler, more natural way to repair deformities caused by single-suture cranial synostosis. The DGA works by reversing the original deforming forces by temporarily restricting growth in areas of over compensation and forcing growth in areas of previous synostotic restriction. Most importantly, it preserves a normal functioning suture to allow for improved future cranial growth. Eighteen consecutive nonsyndromic patients with unilateral coronal synostosis were used to illustrate the efficacy of the DGA. Ten patients who underwent DGA treatment were compared with a control group of 8 patients treated with traditional frontal orbital advancement. Postoperative three-dimensional computed tomography (CT) comparison measurements were taken, including bilateral vertical and transverse orbital dimensions, lateral orbital rim to external auditory canal, and forehead measurements from the superior aspect of the orbital rim to the pituitary fossa. The traditional treatment group showed absence of the coronal sutures bilaterally on long-term CT scans. The DGA group showed normal coronal sutures on the unaffected sides. Postoperative CT measurements showed no statistical difference between the 2 techniques (P < 0.05).

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“…There were statistical differences between the two groups in the area of neurofibroma resection, the length of hospital stay, and the need for blood transfusion. In some other types of surgery, increased blood loss can significantly increase the length of hospital stay [ 16 , 17 ]. Our results also show that intraoperative blood loss can affect the length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for intraoperative hemorrhage of Type I neurofibromatosis

Gao

et al. 2023

BMC Surg

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Introduction Neurofibromatosis (NF) is an inherited disease and a benign tumor originating from nerve sheath cells. Neurofibromatosis type I (NF1) is the most common type, and most cases are characterized by neurofibromas. Neurofibromas in NF1 are mainly treated by surgery. Our study explores the risk factors for intraoperative hemorrhage in Type I neurofibromatosis patients who underwent neurofibroma resection. Methods A cross-sectional comparison of the patients who had undergone resection of neurofibroma for NF1. Data regarding patient characteristics and data about operative outcomes were recorded. The definition of intraoperative hemorrhage group was the intraoperative blood loss greater than 200 ml. Results Of 94 eligible patients, 44 patients were in the hemorrhage group and 50 patients were in the non-hemorrhage group. Multiple logistic regression analysis demonstrated that the area of excision, classification, surgical site, primary surgical, and organ deformation were significant independent predictors of hemorrhage. Conclusion Early treatment can reduce the tumor cross-sectional area, avoid organ deformation, and reduce intraoperative blood loss. For plexiform neurofibroma or neurofibroma of the head and face, the amount of blood loss should be predicted correctly, and preoperative evaluation and blood preparation should be paid more attention to.

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Blood Loss Estimation During Fronto-Orbital Advancement

Cited by 24 publications

References 14 publications

Factors Influencing Blood Loss and Postoperative Morbidity in Children Undergoing Craniosynostosis Surgery: A Retrospective Study

Factors Influencing Blood Loss and Postoperative Morbidity in Children Undergoing Craniosynostosis Surgery: A Retrospective Study

The Directive Growth Approach for Nonsyndromic, Unicoronal Craniosynostosis: Patient and Clinical Outcomes

Risk factors for intraoperative hemorrhage of Type I neurofibromatosis

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