title: Management of children with inherited mild bleeding disorders undergoing adenotonsillar procedures.
abstract: OBJECTIVE
  To evaluate the incidence of perioperative bleeding among children with mild bleeding disorders who underwent adenotonsillar surgery in our hospital and were treated with our perioperative bleeding prophylaxis protocol.
  
  
  METHODS
  Retrospective chart review was aimed at determining the perioperative bleeding rate in children with mild bleeding disorders subjected to our prophylactic protocol while undergoing adenotonsillar procedures. Low von Willebrand factor (LVWF), unspecific platelet function disorders (UPFD) and mild factor VII deficiency were considered as mild bleeding disorders. The protocol utilizes intravenous desmopressin, tranexamic acid, NSAID avoidance, and overnight observation.
  
  
  RESULTS
  Between 2004 and 2009, 44 children with mild bleeding disorders underwent adenotonsillar procedures in our hospital and were treated with the protocol. One patient (LVWF+UPFD) developed perioperative bleeding (2.3%).
  
  
  CONCLUSIONS
  It is possible to obtain low rates of perioperative bleeding in children with mild bleeding disorders undergoing adenotonsillar procedures, provided there is a well-timed diagnosis and an adequate prophylaxis protocol. We believe that further efforts must be directed at preoperative diagnosis of mild bleeding disorders to ensure safer surgeries.
authors.affiliation: Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Raimundo
authors.initials: R
authors.lastname: García-Matte
authors.forename: M
authors.initials: M
authors.lastname: María Constanza Beltrán
authors.forename: A
authors.initials: A
authors.lastname: Ximena Fonseca
authors.forename: C
authors.initials: C
authors.lastname: Pamela Zúñiga
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects* / Q000379:methods; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000601:surgery; D001791:Blood Platelet Disorders / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006474:Hemorrhagic Disorders / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D019990:Perioperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011322:Primary Prevention / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014842:von Willebrand Diseases / Q000175:diagnosis / Q000601:surgery