Validation of a theoretically derived model for the management of massive blood loss in pediatric patients - a case report.
We present the case of a 5-year-old girl who was brought to hospital having suffered an intracranial bleed. She was found to have a large cerebral arteriovenous malformation which was unsuitable for coiling. Uncontrollable raised intracranial pressure refractory to all therapies necessitated surgery as a last resort. Massive hemorrhage eventuated during the procedure with the estimated loss of between five and six blood volumes, the majority occurring within the space of an hour and a half. We describe management using a locally developed protocol and correlate this with laboratory findings.
Paterson
Neil A
NA
Department of Anesthesia, Royal Children's Hospital, Brisbane 4059, Qld, Australia. Neil_Paterson@health.qld.gov.au
D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000379:methods; D001921:Brain / Q000000981:diagnostic imaging; D002675:Child, Preschool; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019586:Intracranial Hypertension / Q000209:etiology / Q000601:surgery; D008353:Mannitol / Q000008:administration & dosage; D008962:Models, Theoretical; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed
D004234:Diuretics, Osmotic; D008353:Mannitol; D015942:Factor VIIa