Improvements in patient blood management for pediatric craniosynostosis surgery using a ROTEM(®) -assisted strategy - feasibility and costs.

摘要: Summary Background: Moderate to severe intraoperative bleeding and the presence of acquired coagulopathy remain serious problems in management major pediatric craniosynostosis surgery. After implementation a ROTEM-assisted patient blood (PBM) strategy, using primarily purified coagulation factor concentrates, feasibility costs this new regimen were analyzed. Methods: Retrospective analysis all consecutive children who underwent primary elective craniofacial surgery for repair was carried out at Children’s University Hospital, Zurich, between 2007 2013. Laboratory workup transfusion requirements compared. Results: A total 47 (36 historic group 11 after PBM) Although patients study needed red cell there avoidance perioperative fresh frozen plasma reduction transfused platelets (one nine vs 36 group) PBM strategy. Based on predefined ROTEM threshold (FibTEM MCF <8 mm), administration fibrinogen concentrate necessary these children. The mean per consisting allogeneic products concentrates reduced by 17.1% (1071.82 EUR before 888.93 implementation). Conclusions: is feasible associated with considerable thereby decrease transfusion-related direct costs.