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Blood-Conservation Techniques in Craniofacial Surgery
Source:
Ann Plast Surg. 2005 May;54(5):525-529
Blood-Conservation Techniques in Craniofacial Surgery.
Meara JG, Smith EM, Harshbarger RJ, Farlo JN, Matar MM, Levy ML.
From the *Royal Children's Hospital, Melbourne, Australia; daggerUniversity of Southern California School of Medicine, Los Angeles, CA; double daggerDepartment of Plastic Surgery, Walter Reed Army Medical Center, Washington, DC; section signDepartment of Anesthesia, Childrens Hospital Los Angeles, Los Angeles, CA; and paragraph signChildren's Hospital and Health Center, San Diego, CA.
Attempts at reducing exposure to allogeneic transfusions, using blood conservation techniques such as controlled hypotension and normovolemic hemodilution, have met with mixed results and are not always practical in small infants. Recombinant human erythropoietin (RHE), a hormone that stimulates RBC production, increases the hematocrit when administered to infants.A retrospective chart review of all patients undergoing fronto-orbital advancement for craniosynostosis by the same plastic surgeon between January 2002 and December 2002 was conducted. A subgroup of patients (10/19) received RHE as a blood-conservation strategy.Transfusion requirements were lower in the RHE group (5/10) versus the control group (9/9). Total volume of blood products transfused was statistically lower in the RHE group (154 mL RHE group versus 421 mL control) (P < 0.03).RHE combined with blood-conservation techniques was associated with a decreased need for blood transfusion, thus exposing the patient to fewer risks associated with allogeneic transfusion.
PMID: 15838215 [PubMed - as supplied by publisher]
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