Journal article
Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction A Multicenter Study from the Pediatric Craniofacial Collaborative Group
Anesthesiology (Philadelphia), v 126(2)
01 Feb 2017
PMID: 27977460
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices.
Methods: Thirty-one institutions contributed data from June 2012 to September 2015. Data extracted included demographics, perioperative management, length of stay, laboratory results, and blood management techniques employed. Complications and outlier events were described. Outcomes analyzed included total blood donor exposures, intraoperative and perioperative transfusion volumes, and length of stay outcomes.
Results: One thousand two hundred twenty-three cases were analyzed: 935 children aged less than or equal to 24 months and 288 children aged more than 24 months. Ninety-five percent of children aged less than or equal to 24 months and 79% of children aged more than 24 months received at least one transfusion. There were no deaths. Notable complications included cardiac arrest, postoperative seizures, unplanned postoperative mechanical ventilation, large-volume transfusion, and unplanned second surgeries. Utilization of blood conservation techniques was highly variable.
Conclusions: The authors present a comprehensive description of perioperative management, outcomes, and complications from a large group of North American children undergoing complex cranial vault reconstruction. Transfusion remains the rule for the vast majority of patients. The occurrence of numerous significant complications together with large variability in perioperative management and outcomes suggest targets for improvement.
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Details
- Title
- Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction A Multicenter Study from the Pediatric Craniofacial Collaborative Group
- Creators
- Paul A. Stricker - Children's Hospital of PhiladelphiaSusan M. Goobie - Boston Children's HospitalFranklyn P. Cladis - University of PittsburghCharles M. Haberkern - University of WashingtonPetra M. Meier - George Washington UniversitySrijaya K. Reddy - Vanderbilt University Medical CenterThanh T. Nguyen - Drexel UniversityLingyu Cai - Children's Medical Center of DallasMarcia Polansky - Drexel UniversityPeter Szmuk - Univ Texas Southwestern Med Sch, Dept Anesthesiol & Pain Management, Childrens Med Ctr Dallas, Dallas, TX USAPediat Craniofacial Collaborative
- Publication Details
- Anesthesiology (Philadelphia), v 126(2)
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 12
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000396916700010
- Scopus ID
- 2-s2.0-85006251439
- Other Identifier
- 991019169663004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Anesthesiology