Successful blood conservation during craniosynostotic correction with dual therapy using procrit and cell saver

TY - JOUR

T1 - Successful blood conservation during craniosynostotic correction with dual therapy using procrit and cell saver

AU - Krajewski, Kara

AU - Ashley, Rebekah K

AU - Pung, Nina

AU - Wald, Sam

AU - Lazareff, Jorge

AU - Kawamoto, Henry K

AU - Bradley, James P

PY - 2008/1

Y1 - 2008/1

N2 - BACKGROUND: Craniosynostotic correction typically performed around infant physiologic nadir of hemoglobin (approximately 3-6 months of age) is associated with high transfusion rates of packed red blood cells and other blood products. As a blood conserving strategy, we studied the use of 1) recombinant human erythropoietin or Procrit (to optimize preoperative hematocrit) and 2) Cell Saver (to recycle the slow, constant ooze of blood during the prolonged case).METHODS: UCLA Patients with craniosynostosis from 2003-2005 were divided into 1) the study group (Procrit and Cell Saver) or 2) the control group (n = 79). The study group 1) received recombinant human erythropoietin at 3 weeks, 2 weeks, and 1 week preoperatively and 2) used Cell Saver intraoperatively. Outcomes were based on morbidities and transfusion rate comparisons.RESULTS: The 2 groups were comparable with regards to age (5.66 and 5.71 months), and operative times (3.11 vs 2.59 hours). In the study group there was a marked increase in preoperative hematocrit (56.2%). The study group had significantly lower transfusions rates (5% vs 100% control group) and lower volumes transfused than in the control group (0.05 pediatric units vs 1.74 pediatric units). Additionally, of the 80% of patients in the study group who received Cell Saver blood at the end of the case, approximately 31% would have needed a transfusion if the recycled blood were unavailable.CONCLUSION: Our data showed that for elective craniosynostotic correction, successful blood conserving dual therapy with Procrit and Cell Saver might be used to decrease transfusion rates and the need for any blood products.

AB - BACKGROUND: Craniosynostotic correction typically performed around infant physiologic nadir of hemoglobin (approximately 3-6 months of age) is associated with high transfusion rates of packed red blood cells and other blood products. As a blood conserving strategy, we studied the use of 1) recombinant human erythropoietin or Procrit (to optimize preoperative hematocrit) and 2) Cell Saver (to recycle the slow, constant ooze of blood during the prolonged case).METHODS: UCLA Patients with craniosynostosis from 2003-2005 were divided into 1) the study group (Procrit and Cell Saver) or 2) the control group (n = 79). The study group 1) received recombinant human erythropoietin at 3 weeks, 2 weeks, and 1 week preoperatively and 2) used Cell Saver intraoperatively. Outcomes were based on morbidities and transfusion rate comparisons.RESULTS: The 2 groups were comparable with regards to age (5.66 and 5.71 months), and operative times (3.11 vs 2.59 hours). In the study group there was a marked increase in preoperative hematocrit (56.2%). The study group had significantly lower transfusions rates (5% vs 100% control group) and lower volumes transfused than in the control group (0.05 pediatric units vs 1.74 pediatric units). Additionally, of the 80% of patients in the study group who received Cell Saver blood at the end of the case, approximately 31% would have needed a transfusion if the recycled blood were unavailable.CONCLUSION: Our data showed that for elective craniosynostotic correction, successful blood conserving dual therapy with Procrit and Cell Saver might be used to decrease transfusion rates and the need for any blood products.

KW - Blood Loss, Surgical

KW - Blood Transfusion

KW - Blood Transfusion, Autologous

KW - Craniosynostoses

KW - Craniotomy

KW - Elective Surgical Procedures

KW - Erythropoietin

KW - Hematinics

KW - Hematocrit

KW - Hemoglobins

KW - Humans

KW - Infant

KW - Injections, Subcutaneous

KW - Intraoperative Care

KW - Postoperative Complications

KW - Premedication

KW - Recombinant Proteins

KW - Reconstructive Surgical Procedures

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1097/scs.0b013e3180f6112f

DO - 10.1097/scs.0b013e3180f6112f

M3 - SCORING: Journal article

C2 - 18216672

VL - 19

SP - 101

EP - 105

JO - J CRANIOFAC SURG

JF - J CRANIOFAC SURG

SN - 1049-2275

IS - 1

ER -