Evidence map›Paper›PMID 26351073›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2016

Minimizing blood transfusions in the surgical correction of craniosynostosis: a 10-year single-center experience.

Christopher M Bonfield, Julia Sharma, D Douglas Cochrane, Ash Singhal, Paul Steinbok

Abstract read
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In one paragraph

Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2018
    Pooled it
  4. 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 · 2026
    Review
  5. Non-syndromic craniosynostosis.Nature reviews. Disease primers · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Christopher M BonfieldDivision of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada. chris.bonfield@vanderbilt.edu.
Julia SharmaDivision of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
D Douglas CochraneDivision of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
Ash SinghalDivision of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
Paul SteinbokDivision of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and BC Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
University of British Columbia · CABC Children's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOur center previously reported low transfusion rates for craniosynostosis surgery by two experienced neurosurgeons using standard intraoperative techniques and acceptance of low hemoglobin levels. This study evaluated whether low rates were maintained over the last 10 years and if a less experienced neurosurgeon, trained in and practicing in the same environment, could achieve similar outcomes.

methodsAll craniosynostosis operations performed in children between 2004 and 2015 were reviewed retrospectively. Transfusion rates were calculated. Analyses examined the relationship of transfusion to craniosynostosis type, surgical procedure, redo operation, surgeon, and perioperative hemoglobin levels.

resultsTwo hundred eighteen patients were included: 71 open sagittal, 28 endoscopic-assisted sagittal, 32 unicoronal, 14 bicoronal, 42 metopic, and 31 multisuture. Median age at operation was 9.1 months. Overall transfusion rate was 24 %: 17 % open sagittal, 7 % endoscopic-assisted sagittal, 6 % unicoronal, 21 % bicoronal, 45 % metopic, and 45 % multisuture. The timing of transfusions were 75, 21, and 4 % for intraoperative, postoperative, and both, respectively. Patients not receiving transfusion had a mean lowest hemoglobin of 87 g/l (range 61-111) intraoperatively and 83 g/l (range 58-115) postoperatively. Mean lowest hemoglobin values were significantly lower in those necessitating intraoperative (75 g/l, range 54-102) or postoperative (59 g/l, range 51-71) transfusions. There was no significant difference in transfusion rate between less and more experienced surgeons. There were no cardiovascular complications or mortalities.

conclusionIn craniosynostosis surgery, reproducible, long-term low blood transfusion rates were able to be maintained at a single center by careful intraoperative technique and acceptance of low intraoperative and postoperative hemoglobin levels in hemodynamically stable patients. Furthermore, low rates were also achieved by an inexperienced neurosurgeon in the group. This suggests that these results may be achievable by other neurosurgeons, who follow a similar protocol.

Indexed as

Blood Loss, SurgicalAdolescentBlood TransfusionChildChild, PreschoolCraniosynostosesEndoscopyFemaleHumansInfantInfant, NewbornLongitudinal StudiesMalePlastic Surgery ProceduresPostoperative ComplicationsTreatment OutcomeBlood transfusionCraniectomyCraniofacial surgeryCraniosynostosis

Identifiers

PMID26351073
OpenAlexW2205565364

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.