Perioperative management of children undergoing craniofacial reconstruction surgery: A practice survey

Paul A. Stricker, Franklyn P. Cladis, John E. Fiadjoe, John McCloskey, Lynne G. Maxwell

Research output: Contribution to journalArticle

Abstract

Objective/Aims: To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. Background: The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children. It is presently unknown to what extent these practices are currently employed. Methods: A web-based survey was sent to representatives from 102 institutions. One individual per institution was surveyed to prevent larger institutions from being over-represented in the results. Results: Requests to complete the survey were sent to 102 institutions; 48 surveys were completed. The survey was composed of two parts: management of infants undergoing strip craniectomies, and management of children undergoing major craniofacial reconstruction. Conclusions: Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.

Original languageEnglish (US)
Pages (from-to)1026-1035
Number of pages10
JournalPaediatric Anaesthesia
Volume21
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Central Venous Pressure
Practice Management
Child Care
Decision Making
Hemodynamics
Surveys and Questionnaires
Clinical Trials
Morbidity
Safety

Keywords

  • anesthesia
  • craniofacial surgery
  • pediatrics
  • transfusion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Perioperative management of children undergoing craniofacial reconstruction surgery : A practice survey. / Stricker, Paul A.; Cladis, Franklyn P.; Fiadjoe, John E.; McCloskey, John; Maxwell, Lynne G.

In: Paediatric Anaesthesia, Vol. 21, No. 10, 10.2011, p. 1026-1035.

Research output: Contribution to journalArticle

Stricker, Paul A. ; Cladis, Franklyn P. ; Fiadjoe, John E. ; McCloskey, John ; Maxwell, Lynne G. / Perioperative management of children undergoing craniofacial reconstruction surgery : A practice survey. In: Paediatric Anaesthesia. 2011 ; Vol. 21, No. 10. pp. 1026-1035.
@article{691ac31a9bd14f90891d5835cdb6580d,
title = "Perioperative management of children undergoing craniofacial reconstruction surgery: A practice survey",
abstract = "Objective/Aims: To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. Background: The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children. It is presently unknown to what extent these practices are currently employed. Methods: A web-based survey was sent to representatives from 102 institutions. One individual per institution was surveyed to prevent larger institutions from being over-represented in the results. Results: Requests to complete the survey were sent to 102 institutions; 48 surveys were completed. The survey was composed of two parts: management of infants undergoing strip craniectomies, and management of children undergoing major craniofacial reconstruction. Conclusions: Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.",
keywords = "anesthesia, craniofacial surgery, pediatrics, transfusion",
author = "Stricker, {Paul A.} and Cladis, {Franklyn P.} and Fiadjoe, {John E.} and John McCloskey and Maxwell, {Lynne G.}",
year = "2011",
month = "10",
doi = "10.1111/j.1460-9592.2011.03619.x",
language = "English (US)",
volume = "21",
pages = "1026--1035",
journal = "Paediatric Anaesthesia",
issn = "1155-5645",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Perioperative management of children undergoing craniofacial reconstruction surgery

T2 - A practice survey

AU - Stricker, Paul A.

AU - Cladis, Franklyn P.

AU - Fiadjoe, John E.

AU - McCloskey, John

AU - Maxwell, Lynne G.

PY - 2011/10

Y1 - 2011/10

N2 - Objective/Aims: To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. Background: The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children. It is presently unknown to what extent these practices are currently employed. Methods: A web-based survey was sent to representatives from 102 institutions. One individual per institution was surveyed to prevent larger institutions from being over-represented in the results. Results: Requests to complete the survey were sent to 102 institutions; 48 surveys were completed. The survey was composed of two parts: management of infants undergoing strip craniectomies, and management of children undergoing major craniofacial reconstruction. Conclusions: Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.

AB - Objective/Aims: To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. Background: The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children. It is presently unknown to what extent these practices are currently employed. Methods: A web-based survey was sent to representatives from 102 institutions. One individual per institution was surveyed to prevent larger institutions from being over-represented in the results. Results: Requests to complete the survey were sent to 102 institutions; 48 surveys were completed. The survey was composed of two parts: management of infants undergoing strip craniectomies, and management of children undergoing major craniofacial reconstruction. Conclusions: Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.

KW - anesthesia

KW - craniofacial surgery

KW - pediatrics

KW - transfusion

UR - http://www.scopus.com/inward/record.url?scp=80052392574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052392574&partnerID=8YFLogxK

U2 - 10.1111/j.1460-9592.2011.03619.x

DO - 10.1111/j.1460-9592.2011.03619.x

M3 - Article

C2 - 21595783

AN - SCOPUS:80052392574

VL - 21

SP - 1026

EP - 1035

JO - Paediatric Anaesthesia

JF - Paediatric Anaesthesia

SN - 1155-5645

IS - 10

ER -