FFP use in paediatric craniofacial surgery

Carver, Edmund D.; Marcus, R.; Tatman, A.

doi:10.1111/j.1460-9592.2010.03294.x

Cited by 6 publications

(8 citation statements)

References 3 publications

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“…This view is supported by Carver et al. who suggest that the potential for significant postoperative blood loss is a consequence of the large areas of exposed bone surfaces that ooze blood (14). However, three patients did develop clinically significant coagulopathies in the postoperative period, these were variable and of mixed origin.…”

Section: Coagulationmentioning

confidence: 89%

“…However, in some cases, the use of cell salvage decreased the incidence and volume of homologous blood transfusion (11), in particular, those which used cell salvage in combination with other blood conservation techniques such as EPO (8,12). A decrease in the average donor exposure from two units of packed red cells to one unit after the introduction of cell salvage has been shown by Dahmani et al and supported by Carver et al (13,14).…”

Section: Cell Salvagementioning

confidence: 95%

“…Indications for the administration of haemostatic blood products depend upon the unit protocol. For example, PT or activated partial thromboplastin time (APTT) values >1.5× normal, fibrinogen <0.8–1 g·l −1 , platelet count <50–80 000 μl −1 or clinical evidence of coagulopathy (2,14,17). When BVL approaches 1.5 × blood volumes, hemostatic blood products may be used empirically (such as FFP and platelets) in the absence of supporting laboratory results in an attempt to correct the anticipated dilutional coagulopathy.…”

Section: Coagulationmentioning

confidence: 99%

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Anesthesia for surgery related to craniosynostosis: a review. Part 2

Hughes

Thomas

Johnson

et al. 2012

Pediatric Anesthesia

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The management of children with craniosynostosis is multidisciplinary and has evolved significantly over the past five decades. The treatment is primarily surgical. The anesthetic challenges continue to be the management of massive blood transfusion and prolonged anesthesia in small children, often further complicated by syndrome-specific issues. This two-part review aims to provide an overview of the anesthetic considerations for these children. The first part described the syndromes associated with craniosynostosis, the provision of services in the UK, surgical techniques, preoperative issues and induction and maintenance of anesthesia. This second part will explore hemorrhage control, the use of blood products, metabolic disturbance and postoperative issues.

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Section: Coagulationmentioning

confidence: 89%

Section: Cell Salvagementioning

confidence: 95%

Section: Coagulationmentioning

confidence: 99%

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Anesthesia for surgery related to craniosynostosis: a review. Part 2

Hughes

Thomas

Johnson

et al. 2012

Pediatric Anesthesia

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“…TXA is a commonly used drug for its antifibrinolytic activity in various surgeries (2)(3)(4)9,19,21). However little known is about how much of the blot-clotting effect expedites postoperative recovery.…”

Section: █ Discussionmentioning

confidence: 99%

Utilization of tranexamic acid in craniosynostosis surgery

Ongun

Dursun²,

Kazan³

2019

Turkish Neurosurgery

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AIM:To analyze the impact of Tranexamic acid (TXA) on perioperative hemodynamics in craniosynostosis surgery.MATERIAL and METHODS: Data of thirty-six children (operated between 2014-2017) were categorized into two groups depending on TXA delivery. Patient demographics, preoperative, intraoperative, postoperative data on hemostasis and metabolic outcomes were recorded. Blood loss from the drains, estimated blood loss (EBV loss), volume of blood transfusions, hemodynamic alerations and complications were extracted. Postoperative outcome involved variables at admission, 2 nd , 6 th , 12 th , 24 th hours. A multiple logistic regression analysis was also performed. RESULTS:Demographics presented mean age of 8.14 ± 3.53 months, male/female ratio:1.76/1, procedure length 3.98 ± 0.78 hours. Intraoperative analysis indicated TXA deliveries manifested fewer blood transfusion volumes (p=0.002) due to lower EBV loss (4.02 ± 1.19 ml/kg vs. 5.97 ± 1.61 ml/kg, p<0.001) with better metabolic outcome.Postoperative outcomes presented all children manifested hematocrit decline after surgey. TXA did not influence postoperative hemodynamic alterations (p=0.090, p=0.112), despite reduced blood loss from the drains and transfusion necessity (p=0.015, p=0.0175). Intraoperative transfusion volumes and EBV loss were associated with postoperative hemodynamics (OR: 3.033, 95% CI: 1.286-7.154; p=0.011; OR: 0.280, 95% CI: 0.081-0.972; p=0.045, respectively). ROC analysis indicated 10.13 ml/kg of intraoperative blood transfusion requirement as the cut off value for hemodynamic instability with 91% sensitivity and 80% specificity. One unit increase in intraoperative transfused blood volume increased the odds of developing hemodynamic alterations by 3.033 times. CONCLUSION:Intraoperative TXA is crucial for successful surgical management; however postoperative period carries out paramount importance due to excessive bleeding after surgery. In case of severe intraoperative transfusion necessity, postoperative TXA utilization might be considered to minimize potential risks by balancing the pros and cons of the drug.

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“…Several blood conservation techniques have been used in an attempt to attenuate the often massive need for blood products in craniofacial surgery . However, the specific management of blood products in the OR remains debated in the literature and in clinical practice .…”

Section: Introductionmentioning

confidence: 99%