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Vol. 35, No. 1, 2001
Issue release date: July 2001
Section title: Original Paper
Pediatr Neurosurg 2001;35:5–12
(DOI:10.1159/000050378)

Abnormal Coagulation during Pediatric Craniofacial Surgery

Williams G.D. · Ellenbogen R.G. · Gruss J.S.
Departments of aAnesthesia, bNeurological Surgery and cPlastic and Craniofacial Surgery, University of Washington, Seattle, Wash., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 7/27/2001

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: http://www.karger.com/PNE

Abstract

Introduction: This prospective study of children undergoing major craniofacial surgery was undertaken to determine whether abnormal hemostasis occurred and to characterize any coagulopathy found. Methods: Coagulation tests, blood loss and blood product transfusions were recorded perioperatively. Packed red blood cells (PRBC) were transfused to maintain target hematocrit. Patients with blood loss >100 ml/kg (group A, n = 5) were compared to patients with blood loss <100 ml/kg (group B, n = 22) using Mann-Whitney U test (p < 0.05). Results: Twenty-seven children (age range 2.9–27.9 months) had median total blood loss of 64 ml/kg. At completion of surgery, median coagulation values differed significantly between groups for prothrombin time (A: 16.6 s; B: 13.8 s), partial thromboplastin time (A: 44 s; B: 29 s), thrombin time (A: 28 s; B: 23 s), thromboelastograph reaction time (A: 7 mm; B: 4 mm), prothrombin fragment F1.2 (A: 1.9 nmol/l; B: 3.3 nmol/l) and platelet count (A: 174 K/mm–3; B: 239 K/mm–3). Fibrinolysis was not associated with blood loss. Median units transfused were in group A 3 units and group B 1 unit (p = 0.001). All patients received PRBC transfusions but only group A patients received other blood products (fresh frozen plasma, platelets). Conclusion: Children transfused with PRBC during craniosynostosis repair can become coagulopathic from coagulation factor depletion when hemorrhage approaches 1.5 times estimated blood volume.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 7/27/2001

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: http://www.karger.com/PNE


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