Preliminary Results of the Implementation of a Patient Blood Management Protocol in the Surgical Correction of Pediatric Scoliosis

Authors

  • Ana Margarida Ferreira Interna do Internato de Formação Específica em Anestesiologia do Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Sónia Nóbrega Interna do Internato de Formação Específica em Anestesiologia do Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
  • Marta Alves Gabinete de Investigação, Epidemiologia e Estatística, Centro Hospitalar Universitário de Lisboa Central, Lisboa,Portugal
  • Daniel Virella Gabinete de Investigação, Epidemiologia e Estatística, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Sara Ramos Interna do Internato de Formação Específica em Anestesiologia do Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal

DOI:

https://doi.org/10.25751/rspa.17186

Keywords:

Blood Loss, Surgical; Blood Transfusion; Child; Clinical Protocols; Erythrocyte Transfusion

Abstract

Background: Pediatric scoliosis surgery, performed to improve quality of life and stop progression of the disease, has significant multifactorial blood loss and consequent consumption of blood products.
A multidisciplinary protocol was implemented to standardize perioperative care and reduce blood product requirements.
Material and Methods: An effectiveness evaluation, with contemporary (protocol “P”; 2016) and historical (pre-protocol “PP”; 2012-2014) cohorts was performed, using a systematic sample of patients aged 2-18 years-old, operated on more than 3 vertebral levels.
Results: Sixty-three patients were recruited: 33 in the PP group and 30 in the P group. Both groups had similar age and weight (median 15 years old and 45 kg), males were more frequent in the group P
(PP 12 vs P 33%). In the P group, the number of patients requiring concentrated erythrocyte unit intraoperative tended to be lower (PP 67% vs P 50%, p = 0.097), more patients received fibrinogen (PP 12%
vs P 33%, p = 0.026) and the amount of fresh frozen plasma transfused tended to be higher (PP 8.6 vs P 13.3 mL/kg, p = 0.091). No statistically significant differences were found on the blood loss. Pre-operatory
haemoglobin tended to be higher in the P group (PP 12.9 vs 13.5 g/ dL, p = 0.079) and the perioperative evolution of haemoglobin levels was different between groups, the haemoglobin level was an average
of 0.45 g/dL higher in the protocol group (p = 0.023).
Conclusion: Multidisciplinary patient blood management protocols may reduce the proportion of patients requiring blood transfusion. 

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References

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Published

2019-05-28

How to Cite

Ferreira, A. M., Nóbrega, S., Alves, M., Virella, D., & Ramos, S. (2019). Preliminary Results of the Implementation of a Patient Blood Management Protocol in the Surgical Correction of Pediatric Scoliosis. Journal of the Portuguese Society of Anesthesiology, 28(2), 90–95. https://doi.org/10.25751/rspa.17186

Issue

Vol. 28 No. 2 (2019): Revista da Sociedade Portuguesa de Anestesiologia

Section

Original Article

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