Blood loss, replacement, and associated morbidity in infants and children undergoing craniofacial surgery.
Paediatr Anaesth
; 20(2): 150-9, 2010 Feb.
Article
em En
| MEDLINE
| ID: mdl-20078812
ABSTRACT
BACKGROUND:
Pediatric craniofacial reconstruction (CFR) procedures involve wide scalp dissections with multiple osteotomies and have been associated with significant morbidity. The aim of this study was to document the incidence of clinically important problems, particularly related to blood loss, and perform a risk factor analysis.METHODS:
Records of all patients who underwent craniofacial surgery at the Children's Hospital of Philadelphia between December 1, 2001 and January 1, 2006 were reviewed. Data were collected from the electronic anesthesia record, intensive care unit (ICU) progress notes, and discharge summary. All intraoperative laboratory values and all laboratory values obtained upon arrival in the ICU were recorded. A multivariable analysis was performed to evaluate associations between elements of intraoperative management and the following clinicaloutcomes:
intraoperative hypotension, intraoperative metabolic acidosis, presence of a postoperative coagulation test abnormality, and postoperative administration of hemostatic blood products.RESULTS:
Data for 159 patients were reviewed. The mean volume of packed red blood cells transfused intraoperatively was 51 ml x kg(-1). Multivariable analysis revealed that intraoperative administration of albumin was strongly correlated with both an increased incidence of postoperative coagulation derangements and postoperative administration of hemostatic blood products (Odds Ratio 5.9, 2.8, respectively), while intraoperative fresh frozen plasma (FFP) administration was associated with an opposite effect (Odds Ratio 0.94, 0.97, respectively).CONCLUSIONS:
In pediatric CFR procedures where the volume of blood loss routinely exceeds one blood volume, intraoperative administration of FFP favorably impacted postoperative laboratory coagulation parameters.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Substitutos Sanguíneos
/
Perda Sanguínea Cirúrgica
/
Anormalidades Craniofaciais
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Procedimentos de Cirurgia Plástica
/
Complicações Intraoperatórias
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
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Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Paediatr Anaesth
Assunto da revista:
ANESTESIOLOGIA
/
PEDIATRIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos