Olivia Vassal1, François-Pierrick Desgranges1, Sylvain Tosetti1, Stéphanie Burgal1, Frédéric Dailler2, Etienne Javouhey3, Carmine Mottolese4, Dominique Chassard1. 1. Department of Pediatric Anesthesia, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France. 2. Department of Anesthesia and Intensive Care Medicine, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France. 3. Department of Pediatric Intensive Care Unit, Femme Mère Enfant Teaching Hospital, Hospices Civils de Lyon, Lyon, France. 4. Department of Pediatric Neurosurgery, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France.
Abstract
BACKGROUND: Several clinical and surgical factors can influence the occurrence of allogeneic blood transfusion (ABT) during oncologic neurosurgery. OBJECTIVES: To identify the potential predictive factors of ABT during craniotomy for the removal of brain tumors in children and the potential impact of intraoperative ABT on early postoperative outcome. METHODS: A retrospective study was performed in all pediatric patients younger than 18 years who underwent craniotomy for brain tumor removal from December 2009 to December 2012 in our institution. Pre-, intra-, and postoperative data were collected from medical and stored electronic anesthesia records. The predictors of intraoperative ABT were determined using multivariate logistic regression. RESULTS: A total of 110 patients were included. Twenty-seven patients (25%) received intraoperative ABT with a volume of 16 ± 8 ml·kg(-1) . On multivariate analysis, an age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) were independently associated with the need for intraoperative ABT. We did not show any significant difference concerning postoperative early outcome and length of stay between the transfused and non-transfused patients except for the duration of postoperative mechanical ventilation that was significantly higher in the transfused group (P = 0.04). CONCLUSION: In children, craniotomy for brain tumor removal is at risk of intraoperative ABT. An age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) are the main factors associated with intraoperative ABT during this surgery.
BACKGROUND: Several clinical and surgical factors can influence the occurrence of allogeneic blood transfusion (ABT) during oncologic neurosurgery. OBJECTIVES: To identify the potential predictive factors of ABT during craniotomy for the removal of brain tumors in children and the potential impact of intraoperative ABT on early postoperative outcome. METHODS: A retrospective study was performed in all pediatric patients younger than 18 years who underwent craniotomy for brain tumor removal from December 2009 to December 2012 in our institution. Pre-, intra-, and postoperative data were collected from medical and stored electronic anesthesia records. The predictors of intraoperative ABT were determined using multivariate logistic regression. RESULTS: A total of 110 patients were included. Twenty-seven patients (25%) received intraoperative ABT with a volume of 16 ± 8 ml·kg(-1) . On multivariate analysis, an age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) were independently associated with the need for intraoperative ABT. We did not show any significant difference concerning postoperative early outcome and length of stay between the transfused and non-transfused patients except for the duration of postoperative mechanical ventilation that was significantly higher in the transfused group (P = 0.04). CONCLUSION: In children, craniotomy for brain tumor removal is at risk of intraoperative ABT. An age <4 years, a duration of surgery >270 min, and a preoperative hemoglobin <12.2 g·dl(-1) are the main factors associated with intraoperative ABT during this surgery.
Authors: Carlito Lagman; John P Sheppard; Joel S Beckett; Alexander M Tucker; Daniel T Nagasawa; Giyarpuram N Prashant; Alyssa Ziman; Isaac Yang Journal: J Neurol Surg B Skull Base Date: 2018-05-14
Authors: Marie E Steiner; Nicole D Zantek; Simon J Stanworth; Robert I Parker; Stacey L Valentine; Leslie E Lehmann; Cassandra D Josephson; Scot T Bateman; Naomi L C Luban Journal: Pediatr Crit Care Med Date: 2018-09 Impact factor: 3.624