Effect of Erythropoietin on Transfusion Requirements for Craniosynostosis Surgery in Children

Aljaaly, Hattan; Aldekhayel, Salah; Diaz-Abele, Julian; Karunanayka, Mihiran; Gilardino, Mirko S.

doi:10.1097/scs.0000000000003717

Cited by 24 publications

(14 citation statements)

References 29 publications

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“…Restrictive transfusion strategies compared to liberal strategies in critically ill patients did not increase adverse outcome. Maintaining a hemoglobin level target of 12 g/dL or more maybe not necessary in all patients and should be assessed according to patients global status and co-existing comorbidities like congenital heart disease, prematurity, sepsis etc… Preoperative erythropoietin has been reported to reduce blood product transfusion in craniosynostosis surgery, integrating this molecule with iron supplementation in blood transfusion management protocols in this surgery could contribute to reduce the rate of intraoperative transfusions (29).…”

Section: Discussionmentioning

confidence: 99%

Patient Blood Management in Craniosynostosis Surgery

Kumba

2021

Preprint

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Background: Craniosynostosis surgery is one of the most hemorrhagic interventions, where transfusion rates vary from 20 to 100% depending on the study.Objective: To describe intraoperative and postoperative outcomes in a secondary analysis of children who underwent craniosynostosis surgery included in the initial retrospective study with the aim of proposing intraoperative implementation optimization protocols for postoperative outcome improvement.Methods: Secondary analysis. The study was approved by the Ethics Committee.Results: There were 69 children with a median age of 10 [0-207] months.Eight (11.6%) patients had intraoperative and/or postoperative complications. One patient (1.5%) had intraoperative hemorrhagic shock, and two patients (2.9%) had intraoperative broncholaryngospasm. One patient (1.5%) had postoperative anaphylaxis. One patient (1.5%) had postoperative hemorrhagic shock. One patient (1.5%) had postoperative respiratory failure. Two patients (2.9%) had postoperative neurologic failure. One patient (1.5%) had neuro-meningeal sepsis. One patient (1.5%) had a re-operation. There was no in-hospital mortality.Fourty-eight patients (69.6%) had intraoperative transfusions.Conclusion: Transfusion protocols guided with point-of-care tests should be included in patient blood management programs in craniosynostosis surgery.

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Section: Discussionmentioning

confidence: 99%

Patient Blood Management in Craniosynostosis Surgery

Kumba

2021

Preprint

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“…Preoperative erythropoietin has been reported to reduce blood product transfusion in craniosynostosis surgery, and integrating this molecule with iron supplementation in blood transfusion management protocols in this surgery could contribute to reducing the rate of intraoperative transfusions [29].…”

Section: Discussionmentioning

confidence: 99%

Patient Blood Management in Craniosynostosis Surgery

Kumba¹

2021

OJMN

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Background: Craniosynostosis surgery is one of the most hemorrhagic interventions, where transfusion rates vary from 20% to 100% depending on the study. Objective: To describe intraoperative and postoperative outcomes in a secondary analysis of children who underwent craniosynostosis surgery included in the initial retrospective study with the aim of proposing intraoperative implementation optimization protocols for postoperative outcome improvement. Methods: Secondary analysis. The study was approved by the Ethics Committee. Results: There were 69 children with a median age of 10 [0 -207] months. Eight (11.6%) patients had intraoperative and/or postoperative complications. One patient (1.5%) had intraoperative hemorrhagic shock, and two patients (2.9%) had intraoperative broncholaryngospasm. One patient (1.5%) had postoperative anaphylaxis. One patient (1.5%) had postoperative hemorrhagic shock. One patient (1.5%) had postoperative respiratory failure. Two patients (2.9%) had postoperative neurologic failure. One patient (1.5%) had neuro-meningeal sepsis. One patient (1.5%) had a re-operation. There was no in-hospital mortality. Fourty-eight patients (69.6%) had intraoperative transfusions. Conclusion: Transfusion protocols guided with point-of-care tests should be included in patient blood management programs in craniosynostosis surgery.

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“…[ 1 ]. Considering the requirement for a larger volume of blood transfusion during two-stage epilepsy surgeries, a special strategy—similar to that for pediatric cardiac surgery [ 12 , 13 ]—may be needed to enhance hematopoiesis using iron replacement or recombinant erythropoietin or to minimize intraoperative bleeding using antifibrinolytic agents [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Bleeding properties according to surgical sites during pediatric craniotomy: a retrospective study comparing the two stages of epilepsy surgery

et al. 2020

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Background: During pediatric epilepsy surgery, due to low circulating blood volume, intraoperative bleeding can result in significant hemodynamic instability, thereby requiring meticulous hemodynamic and transfusion strategies. Knowing the source of bleeding during the procedure would allow medical staff to better prepare the perioperative protocols for these patients. We compared intraoperative bleeding between the first (involving skin to meninges) and second (involving brain parenchyma) stages of epilepsy surgery to investigate the differences between various anatomical sites.Methods: We reviewed the electronic medical records of 102 pediatric patients < 14 years old who underwent two-stage epilepsy surgeries during January 2012–2016. Invasive subdural grids were placed via craniotomy during Stage 1 and the epileptogenic zone was removed during Stage 2 of the surgery. We compared the volume of intraoperative bleeding between these two surgeries and identified variables associated with bleeding using multivariate regression analysis.Results: Both surgeries resulted in similar intraoperative bleeding (24 vs. 26 ml/kg, P = 0.835), but Stage 2 required greater volumes of blood transfusion than Stage 1 (18.4 vs. 14.8 ml/kg, P = 0.011). Massive bleeding was associated with patients < 7 years old in Stage 1 and weighing < 18 kg in Stage 2.Conclusions: The volume of intraoperative bleeding was similar between the two stages of pediatric epilepsy surgery and was large enough to require blood transfusions. Thus, blood loss during pediatric epilepsy surgery occurred at both anatomic sites. This indicates the necessity of early preparation for blood transfusion in both stages of pediatric epilepsy surgery.

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Effect of Erythropoietin on Transfusion Requirements for Craniosynostosis Surgery in Children

Cited by 24 publications

References 29 publications

Patient Blood Management in Craniosynostosis Surgery

Patient Blood Management in Craniosynostosis Surgery

Patient Blood Management in Craniosynostosis Surgery

Bleeding properties according to surgical sites during pediatric craniotomy: a retrospective study comparing the two stages of epilepsy surgery

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