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A Transfusion Regimen With Same-donor Packed Red Blood Cells Reduces Exposure to Multiple Blood Donors in Craniosynostosis Surgery
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.ORCID iD: 0000-0003-2716-4614
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Vascular Biology.ORCID iD: 0000-0001-9511-6740
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurosurgery.ORCID iD: 0000-0003-4364-1919
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2024 (English)In: The Journal of Craniofacial Surgery, ISSN 1049-2275, E-ISSN 1536-3732, Vol. 35, no 5, p. 1352-1355Article in journal (Refereed) Published
Abstract [en]

In major craniosynostosis surgery with moderate to severe blood loss, patients may be exposed to multiple donors. We have previously reported a method for reducing donor exposure using mixed pediatric units including plasma. To further reduce donor exposure, we used plasma-free divided pediatric units. The study aimed to investigate the feasibility of the new strategy for reducing donor exposure. This prospective observational study recruited children younger than 1 year who were scheduled for nonsyndromic craniosynostosis surgery. One adult red blood cell unit was divided into 4 equal units on the day before the operation for use intra- or postoperatively. Number of donor exposures, estimated blood loss, crystalloid, colloid, and blood product volumes, and coagulation parameters were evaluated. Nineteen infants were included. The mean estimated blood loss was 19 (3) mL/kg and the transfusion volume was 17 (7) mL/kg. The median donor exposure per patient was 1 (range, 1-3). During surgery, all infants received at least one DPU. Two infants received transfusions from more than one donor during the intraoperative period. In the first 24 hours postoperatively, 14 infants received transfusion; 10 received only DPUs, whereas 4 received from multiple donors. In all, multiple donor exposure was prevented in 14 of 19 infants. Postoperative Pk-INR was 1.33 (0.16); no plasma or platelets were transfused. The plasma-free DPU transfusion protocol may be useful to reduce donor exposure in open craniosynostosis surgery in infants.

Place, publisher, year, edition, pages
Wolters Kluwer, 2024. Vol. 35, no 5, p. 1352-1355
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Surgery
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URN: urn:nbn:se:uu:diva-542520DOI: 10.1097/SCS.0000000000010165ISI: 001261492000045PubMedID: 38709036OAI: oai:DiVA.org:uu-542520DiVA, id: diva2:1912608
Available from: 2024-11-12 Created: 2024-11-12 Last updated: 2024-11-14Bibliographically approved

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Mogensen, StefanLubenow, NorbertEnblad, PerNilsson, PelleNowinski, DanielFrykholm, Peter

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