Abstract
Normal blood coagulation is essential in pediatric neurosurgery because of the risk of abundant bleeding, and therefore it is important to avoid transfusion of fluids that might interfere negatively with the coagulation process. There is a lack of transfusion guidelines in massive bleeding with pediatric neurosurgical patients, and early use of blood compounds is partly controversial. We describe two pediatric patients for whom fresh frozen plasma (FFP) infusion was started at the early phase of brain tumor surgery to prevent intraoperative coagulopathy and hypovolemia. In addition to the traditional laboratory testing, modified thromboelastometry analyses were used to detect possible disturbances in coagulation. Early transfusion of FFP and red blood cells preserved the whole blood coagulation capacity. Even with continuous FFP infusion, fibrin clot firmness was near to critical value at the end of surgery despite increased preoperative values. By using FFP instead of large amounts of crystalloids and colloids when major blood loss is expected, blood coagulation is probably less likely to be impaired. Our results indicate, however, that the capacity of FFP to correct fibrinogen deficit is limited.
References
Jan 1, 1991·International Journal of Clinical Monitoring and Computing·P MartinD R Walker
Feb 27, 2004·British Journal of Haematology·Brenda E S GibsonG Turner
Jun 17, 2004·British Journal of Haematology·D F O'ShaughnessyUNKNOWN British Committee for Standards in Haematology, Blood Transfusion Task Force
Mar 23, 2006·Anesthesia and Analgesia·Tomi T NiemiAnne H Kuitunen
Apr 20, 2007·The New England Journal of Medicine·Jacques LacroixUNKNOWN Pediatric Acute Lung Injury and Sepsis Investigators Network
Oct 31, 2007·Neurocritical Care·Joseph L NatesKristen J Price
Feb 23, 2008·Anesthesia and Analgesia·Thorsten HaasPetra Innerhofer
Sep 12, 2008·The Journal of Trauma·Oliver L GunterBryan A Cotton
Nov 21, 2008·Medical Oncology·O Meltem AkayZafer Gulbas
May 19, 2009·Anesthesia and Analgesia·Beth H ShazChristopher D Hillyer
Oct 7, 2009·Transfusion·Beth H ShazChristopher D Hillyer
Oct 10, 2009·Journal of Neurosurgical Anesthesiology·Ann-Christine LindroosTomi Niemi
Apr 15, 2010·British Journal of Anaesthesia·A SchramkoT Niemi
Oct 5, 2010·Seminars in Pediatric Surgery·Jeffrey J Dehmer, William T Adamson
Dec 16, 2010·Paediatric Anaesthesia·Josée Lavoie
Mar 3, 2011·Anesthesiology·Susan M GoobieNavil F Sethna
Mar 4, 2011·Neurocritical Care·Teemu LuostarinenTomi Niemi
Mar 18, 2011·The Cochrane Database of Systematic Reviews·Arash AfshariJørn Wetterslev
Jul 7, 2011·Cardiology in the Young·Jo Bønding AndreasenHanne Berg Ravn
Sep 20, 2011·The Journal of Trauma·John B HolcombB Marin
Nov 19, 2011·Acta Anaesthesiologica Scandinavica·A J WikkelsoeA M Moeller
Citations
Nov 18, 2015·Paediatric Anaesthesia·Olivia VassalDominique Chassard
Dec 15, 2015·PloS One·Naili WeiJianguo Zhang
Nov 2, 2017·Neurosurgical Focus·Svetlana KvintMonisha A Kumar
Sep 3, 2013·Current Opinion in Anaesthesiology·Federico BilottaGiovanni Rosa
Aug 8, 2019·Pediatric Neurosurgery·Daniel H FulkersonMark Walsh