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 language | English (US) |
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Pages (from-to) | 1026-1035 |
Number of pages | 10 |
Journal | Paediatric anaesthesia |
Volume | 21 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2011 |
Externally published | Yes |
Keywords
- anesthesia
- craniofacial surgery
- pediatrics
- transfusion
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Anesthesiology and Pain Medicine