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Predictors of transfusion outcomes in pediatric complex cranial vault reconstruction: a multicentre observational study from the Pediatric Craniofacial Collaborative Group
Journal article   Open access   Peer reviewed

Predictors of transfusion outcomes in pediatric complex cranial vault reconstruction: a multicentre observational study from the Pediatric Craniofacial Collaborative Group

Patrick G Fernandez, Brad M Taicher, Susan M Goobie, Meera Gangadharan, H Mayumi Homi, Jane A Kugler, Rochelle Skitt, Lingyu Cai, Marcia Polansky, Paul A Stricker, …
Canadian journal of anesthesia, v 66(5), pp 512-526
May 2019
DOI: https://doi.org/10.1007/s12630-019-01307-w
PMID: 30767183
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1007/s12630-019-01307-wView
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Age Factors Anemia - epidemiology Antifibrinolytic Agents - administration & dosage Blood Loss, Surgical Blood Transfusion - statistics & numerical data Child, Preschool Craniosynostoses - surgery Female Hospitalization - statistics & numerical data Humans Infant Male Preoperative Period Reconstructive Surgical Procedures - methods Registries Risk Factors
Pediatric patients undergoing complex cranial vault reconstruction (CCVR) are at risk of significant perioperative blood loss requiring blood product transfusion. Minimizing allogeneic blood product transfusion is an important goal because of the associated risks and cost. The impact of patient and surgical variables on transfusion is unknown in this population. Our primary aim was to examine relationships between demographic and perioperative variables and blood product transfusion outcomes in CCVR. The multicentre Pediatric Surgery Perioperative Registry was checked for children undergoing CCVR between June 2012 and September 2016. Univariable and multivariable analyses were performed examining patient, procedure, and blood conservation variables and their relationship to three outcomes: intraoperative red blood cell-containing product (RBC-CP) transfusion, total perioperative blood donor exposures, and transfusion-free hospitalization. The registry search returned data from 1,814 cases. Age and surgical duration were the only variables significantly associated with all three outcomes studied. Predictors of reduced RBC-CP transfusion included lower American Society of Anesthesiologists (ASA) physical status and antifibrinolytic administration. Total cranial vault reconstruction, intraoperative vasoactive infusion, and presence of a tracheostomy predicted increased donor exposures. Increased body weight, higher preoperative hematocrit, and utilization of intraoperative cell saver and transfusion protocols were associated with transfusion-free hospitalization. Clinical factors associated with increased allogeneic blood product transfusion in pediatric CCVR include: age ≤ 24 months, ASA status ≥ III, preoperative anemia, prolonged surgical duration, lack of intraoperative antifibrinolytic use, lack of intraoperative cell saver use, and the lack of transfusion protocols.

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19 citations in Web of Science
22 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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Collaboration types
Domestic collaboration
Web of Science research areas
Anesthesiology
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