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

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

Research output: Contribution to journalReview articlepeer-review

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 1 2011
Externally publishedYes

Keywords

  • anesthesia
  • craniofacial surgery
  • pediatrics
  • transfusion

ASJC Scopus subject areas

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

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