Association between perioperative surgical home implementation and transfusion patterns in adolescents with idiopathic scoliosis undergoing spinal fusion

Paediatric Anaesthesia
Jessica CroninSophie R Pestieau

Abstract

Blood transfusions in patients with adolescent idiopathic scoliosis after fusion have been associated with increased morbidity, mortality, and cost. The aim of this study was to evaluate the association between implementation of blood-conservation strategies within the perioperative surgical home on transfusion rates for patients with adolescent idiopathic scoliosis undergoing spinal fusion. Two hundred and thirteen patients (44 preperioperative surgical home, 169 postperioperative surgical home) who underwent posterior spine fusion for adolescent idiopathic scoliosis between 23 June 2014, and 30 July 2017, were enrolled in this case control study. The perioperative surgical home implemented in March 2015 involved evidence-based perioperative interventions to create a standardized clinical pathway including judicious use of crystalloid management, restrictive transfusion strategy, routine use of cell saver, and standardized administration of anti-fibrinolytics. The primary outcome was odds of perioperative transfusion. Secondary outcomes included volumes of crystalloid, albumin, cell saver, packed red blood cells as well as calculated blood loss. Other variables that were documented included antibrinolytic total dose, mean arte...Continue Reading

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Citations

Jun 6, 2019·Paediatric Anaesthesia·Robert G Hahn, Azriel Perel
Jul 10, 2019·Paediatric Anaesthesia·Jessica A CroninSophie R Pestieau
Mar 13, 2021·Paediatric Anaesthesia·Christopher ConleyLynne Ferrari
Apr 27, 2021·Spine Deformity·Mark J McVeyR Zeller

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