title: Factors influencing blood loss and allogeneic blood transfusion practice in craniosynostosis surgery.
abstract: OBJECTIVE
  To identify factors influencing perioperative blood loss and transfusion practice in craniosynostotic corrections.
  
  
  BACKGROUND
  Craniosynostotic corrections are associated with large amounts of blood loss and high transfusion rates.
  
  
  METHODS
  A retrospective analysis was performed of all pediatric craniosynostotic corrections during the period from January 2003 to October 2009. The primary endpoint was the receipt of an allogeneic blood transfusion (ABT) during or after surgery. Pre-, intra-, and postoperative data were acquired using the electronic hospital registration systems and patients' charts.
  
  
  RESULTS
  Forty-four patients were operated using open surgical techniques. The mean estimated blood loss during surgery was 55 ml·kg(-1). In 42 patients, red blood cells were administered during or after surgery with a mean of 38 ml·kg(-1). In 23 patients, fresh frozen plasma was administered with a mean of 28 ml·kg(-1). A median of two different donors per recipient was found. Longer duration of surgery and lower bodyweight were associated with significantly more blood loss and red blood cell transfusions. Higher perioperative blood loss and surgery at an early age were correlated with a longer duration of admission.
  
  
  CONCLUSIONS
  In this study, craniosynostotic corrections were associated with large amounts of blood loss and high ABT rates. The amount of ABT could possibly be reduced by appointing a dedicated team of physicians, by using new less-invasive surgical techniques, and by adjusting anesthetic techniques.
authors.affiliation: Division of Anesthesia, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Allon
authors.initials: A
authors.lastname: van Uitert
authors.forename: Johanna H A M
authors.initials: JH
authors.lastname: Megens
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.forename: Bart M
authors.initials: BM
authors.lastname: Stubenitsky
authors.forename: K Sen
authors.initials: KS
authors.lastname: Han
authors.forename: Jurgen C
authors.initials: JC
authors.lastname: de Graaff
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001804:Blood Transfusion, Autologous / Q000379:methods* / Q000706:statistics & numerical data*; D001835:Body Weight; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome