Patient Blood Management in Craniosynostosis Surgery

Background: Craniosynostosis surgery is one of the most hemorrhagic interventions, where transfusion rates vary from 20 to 100% depending on the study. Objective: To describe intraoperative and postoperative outcomes in a secondary analysis of children who underwent craniosynostosis surgery included in the initial retrospective study with the aim of proposing intraoperative implementation optimization protocols for postoperative outcome improvement. Methods: Secondary analysis. The study was approved by the Ethics Committee. Results: There were 69 children with a median age of 10 [0-207] months.Eight (11.6%) patients had intraoperative and/or postoperative complications. One patient (1.5%) had intraoperative hemorrhagic shock, and two patients (2.9%) had intraoperative broncholaryngospasm. One patient (1.5%) had postoperative anaphylaxis. One patient (1.5%) had postoperative hemorrhagic shock. One patient (1.5%) had postoperative respiratory failure. Two patients (2.9%) had postoperative neurologic failure. One patient (1.5%) had neuro-meningeal sepsis. One patient (1.5%) had a re-operation. There was no in-hospital mortality.Fourty-eight patients (69.6%) had intraoperative transfusions. Conclusion: Transfusion protocols guided with point-of-care tests should be included in patient blood management programs in craniosynostosis surgery.