ArticlePaediatric anaesthesia2014
Improvements in patient blood management for pediatric craniosynostosis surgery using a ROTEM(®) -assisted strategy - feasibility and costs.
Article in Paediatric anaesthesia, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 156 citations in OpenAlex.
- Plasma and Platelet Transfusions Strategies in Neonates and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass or Neonates and Children Supported by Extracorporeal Membrane Oxygenation: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Pooled it
- Plasma and Platelet Transfusion Strategies in Critically Ill Children Following Noncardiac Surgery and Critically Ill Children Undergoing Invasive Procedures Outside the Operating Room: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Pooled it
- Indications for and strategies to reduce blood transfusion for craniosynostosis surgery: a narrative review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- The Role of Viscoelastic Testing in Assessing Hemostasis: A Challenge to Standard Laboratory Assays?Journal of clinical medicine · 2024Review
- Effect of Prophylactic Fibrinogen Concentrate In Scoliosis Surgery (EFISS): a study protocol of two-arm, randomised trial.BMJ open · 2023Article
- Prophylactic administration of tranexamic acid combined with thromboelastography-guided hemostatic algorithm reduces allogeneic transfusion requirements during pediatric resective epilepsy surgery: A randomized controlled trial.Frontiers in pharmacology · 2022Article
- Establishing reference ranges of cord blood: point-of-care hemostatic function assessment in preterm and term neonates.Pediatric research · 2021Observational
- Enhanced Recovery Protocol after Fronto-orbital Advancement Reduces Transfusions, Narcotic Usage, and Length of Stay.Plastic and reconstructive surgery. Global open · 2020Article
- Minimizing Blood Loss in Spine Surgery.Global spine journal · 2020Article
- [Intracranial hemorrhage secondary to vitamin K deficiency in an infant despite oral vitamin K prophylaxis : Also a challenge for the anesthesiologist].Der Anaesthesist · 2017Article
- Minimizing blood transfusions in the surgical correction of craniosynostosis: a 10-year single-center experience.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2016Article
- Use of blood-sparing surgical techniques and transfusion algorithms: association with decreased blood administration in children undergoing primary open craniosynostosis repair.Journal of neurosurgery. Pediatrics · 2015Article
- Effect of coagulation factor concentrate administration on ROTEM® parameters in major trauma.Scandinavian journal of trauma, resuscitation and emergency medicine · 2015Observational
- Comparison of fibrin-based clot elasticity parameters measured by free oscillation rheometry (ReoRox ®) versus thromboelastometry (ROTEM ®).Scandinavian journal of clinical and laboratory investigation · 2015Article
- Intraoperative optimization to decrease postoperative PRBC transfusion in children undergoing craniofacial reconstruction.Paediatric anaesthesia · 2015Article
- A general review of major global coagulation assays: thrombelastography, thrombin generation test and clot waveform analysis.Thrombosis journal · 2015Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundModerate to severe intraoperative bleeding and the presence of acquired coagulopathy remain serious problems in the management of major pediatric craniosynostosis surgery. After implementation of a ROTEM(®) -assisted patient blood management (PBM) strategy, using primarily purified coagulation factor concentrates, feasibility and costs of this new regimen were analyzed.
methodsRetrospective analysis of all consecutive children who underwent primary elective major craniofacial surgery for craniosynostosis repair was carried out at the Children's University Hospital, Zurich, between 2007 and 2013. Laboratory workup and transfusion requirements were compared.
resultsA total of 47 children (36 in the historic group and 11 after implementation of PBM) were analyzed. Although all patients in this study needed transfusion of red blood cell concentrates, there was a total avoidance of perioperative transfusion of fresh frozen plasma and a reduction in transfused platelets (one of nine children vs nine of 36 children in the historic group) after implementation of the PBM strategy. Based on a predefined ROTEM(®) threshold in the PBM group (FibTEM MCF <8 mm), administration of fibrinogen concentrate was necessary in all of these children. The mean total costs per patient consisting of transfused allogeneic blood products and coagulation factor concentrates were reduced by 17.1% after implementation of PBM (1071.82 EUR per patient before vs 888.93 EUR after implementation).
conclusionsThe implementation of a ROTEM(®) -assisted PBM is feasible and is associated with a considerable reduction in intraoperative transfusion requirements and thereby a decrease in transfusion-related direct costs.
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