Impact of multidisciplinary engagement in a quality improvement blood conservation protocol for craniosynostosis.

Journal of Neurosurgery. Pediatrics
David E KurlanderKrystal L Tomei

Abstract

Patients undergoing open cranial vault remodeling for craniosynostosis frequently experience substantial blood loss requiring blood transfusion. Multiple reports in the literature have evaluated the impact of individual blood conservation techniques on blood transfusion rates during craniosynostosis surgery. The authors engaged a multidisciplinary team and assessed the impact of input from multiple stakeholders on the evolution of a comprehensive quality improvement protocol aimed at reducing or eliminating blood transfusion in patients undergoing open surgery for craniosynostosis. Over a 4-year period from 2012 to 2016, 39 nonsyndromic patients were operated on by a single craniofacial plastic surgeon. Initially, no clear blood conservation protocol existed, and specific interventions were individually driven. In 2014, a new pediatric neurosurgeon joined the craniofacial team, and additional stakeholders in anesthesiology, transfusion medicine, critical care, and hematology were brought together to evaluate opportunities for developing a comprehensive blood conservation protocol. The initial version of the protocol involved the standardized administration of intraoperative aminocaproic acid (ACA) and the use of a cell saver. I...Continue Reading

References

Oct 1, 1995·Journal of Pediatric Surgery·J R Hocker, K L Saving
Jan 9, 1999·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·F VelardiF Stoppa
Jul 22, 1999·Journal of Neurosurgical Anesthesiology·L W FaberowskiJ P Mickle
Oct 16, 1999·Anaesthesia and Intensive Care·S G Buntain, M Pabari
Dec 22, 1999·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·F VelardiC Di Rocco
Jan 15, 2000·Journal of Neurosurgical Anesthesiology·P HansM Lamy
Jan 12, 2002·Plastic and Reconstructive Surgery·Anand K DevaJoseph G McCarthy
Apr 20, 2005·Annals of Plastic Surgery·John G MearaMike L Levy
Sep 30, 2005·Anesthesia and Analgesia·Douglas G RirieLouis C Argenta
Apr 20, 2007·The New England Journal of Medicine·Jacques LacroixUNKNOWN Pediatric Acute Lung Injury and Sepsis Investigators Network
Sep 25, 2008·The Journal of Craniofacial Surgery·Christian DuncanMark Caswell
Nov 26, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Tamás BreuerPeter Tassani
Dec 4, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·David HenryAndreas Laupacis
Feb 4, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Esther S SchoutenCasper W Bollen
Dec 1, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Klaus MartinGunther Wiesner
Dec 16, 2010·Paediatric Anaesthesia·Josée Lavoie
Jan 29, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Klaus MartinGunther Wiesner
May 21, 2011·Paediatric Anaesthesia·Paul A StrickerLynne G Maxwell
Nov 3, 2011·Journal of Neurosurgery. Pediatrics·Mitchel SeruyaRobert F Keating
Jan 24, 2012·The Journal of Thoracic and Cardiovascular Surgery·Sara K PasqualiJeffrey P Jacobs
Feb 9, 2012·Anaesthesia and Intensive Care·Peter W Howe, Michael G Cooper
Oct 4, 2013·Paediatric Anaesthesia·Matthew D SjoblomSenthilkumar Sadhasivam
Nov 19, 2013·The Journal of Craniofacial Surgery·Adam J OppenheimerSteven R Buchman
Jun 1, 2014·Journal of Neurosurgery. Pediatrics·Rafael A VegaJennifer L Rhodes
Nov 19, 2015·Annals of Neurology·Irene LeckerBeverley A Orser
Jul 28, 2016·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Raphael StehrerJens Meier
Feb 18, 2017·Paediatric Anaesthesia·Susan M GoobieUNKNOWN the Pediatric Craniofacial Collaborative Group

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