Minimizing transfusion in sagittal craniosynostosis surgery: the Children’s Hospital of Minnesota Protocol

• Published in: Child's nervous system 2019-08, Vol.35 (8), p.1357-1362
• Main Authors: Escher, Paul J., Tu, Albert, Kearney, Susan, Wheelwright, Matthew, Petronio, Joseph, Kebriaei, Meysam, Chinnadurai, Sivakumar, Tibesar, Robert J.
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Original Article
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-019-04157-5

Purpose To assess the success of a protocol using preoperative erythropoietin (EPO) and iron with perioperative tranexamic acid (TXA) in reducing blood transfusion in sagittal craniosynostosis surgery. Methods A retrospective chart review of all sagittal craniosynostosis patients undergoing open repair at our institution since 2010 was conducted. A novel protocol of preoperative EPO with iron and perioperative TXA, along with a shift away from automatic transfusion, was initiated in 2014. Perioperative hemoglobin levels, length of stay, and transfusion rates were compared between the historical control and the study group receiving the protocol. Results A total of 36 patients met inclusion criteria. Twenty-eight patients were male and 8 were female. Twenty-two patients were in the control group receiving neither TXA nor EPO and automatically received a transfusion, while 14 were in the study group and received the full protocol. There were no significant demographic differences between groups. Within the control group, 100% of patients were transfused compared with 14.3% of the study group ( p