"No allogeneic blood transfusion" protocol for the surgical correction of craniosynostoses. I. Rationale.
Improved anesthesiological and surgical care has resulted in a progressively declining need for allogeneic blood transfusion. In infants with craniosynostosis, however, allogeneic blood transfusion is still performed as a routine procedure. In the present paper, the authors describe a protocol they have devised with the aim of limiting or even avoiding allogeneic blood transfusion even in very young patients, consequently avoiding the risks of infective or immunologic reactions associated with the procedure. The protocol is based on stimulation of the hematopoietic system with erythropoietin, selection of an appropriate age for operation when a favorable balance between fetal and adult-type hemoglobin is established (that is after 4-6 months), preoperative preparation of the autologous blood supply, and intraoperative blood salvage.
Velardi
F
F
Section of Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Rome, Italy. md9857@mclink.it
Di Chirico
A
A
Di Rocco
C
C
Fundarò
C
C
Serafini
R
R
Piastra
M
M
Viola
L
L
Pietrini
D
D
Pusateri
A
A
Stoppa
F
F
D000367:Age Factors; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002675:Child, Preschool; D002985:Clinical Protocols; D003398:Craniosynostoses / Q000601:surgery*; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative; D011182:Postoperative Care; D011300:Preoperative Care; D013997:Time Factors
D006454:Hemoglobins