2017
DOI: 10.1097/scs.0000000000003717 View full text |Buy / Rent full text
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Abstract: The present meta-analysis demonstrated that preoperative administration of EPO in pediatric craniosynostosis surgery decreased the proportion of patients requiring ABT. In addition, the volume of transfusion was reduced in patients who received EPO. Future randomized studies are needed to establish the cost-effectiveness of routine preoperative EPO administration in craniosynostosis surgery.

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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
“…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
“…[ 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
“…At a preoperative clinic visit, around 6 months of age, a baseline hemoglobin is obtained, and all children less than 18 months of age are offered recombinant EPO to increase red cell mass. 24 After obtaining informed consent, recombinant EPO (600 units/kg) is initiated 3 weeks before surgery, and on average, requires 2–3 weekly doses. Hemoglobin level is checked before each injection, and EPO is held when the level is ≥15g/dL.…”
Section: Methodsmentioning
“…This protocol illustrated a decreased rate and volume of intraoperative transfusion compared to controls, a lower required dose of postoperative morphine, and shorter overall hospital stay compared with controls [8 ▪ ]. Despite known reports of increased vascular thrombosis, risk of cancer progression, and cardiovascular complications with EPO use in the adult population, these adverse events have not been observed in pediatric patients [9].…”
Section: Preadmission Optimizationmentioning