Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction: A Multicenter Study from the Pediatric Craniofacial Collaborative Group.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stricker Paul A, Goobie Susan M, Cladis Franklyn P, Haberkern Charles M, Meier Petra M, Reddy Srijaya K, Nguyen Thanh T, Cai Lingyu, Polansky Marcia, Szmuk Peter, Fiadjoe John, Soneru Codruta, Falcon Ricardo, Petersen Timothy, Kowalczyk-Derderian Courtney, Dalesio Nicholas, Budac Stefan, Groenewald Neels, Rubens Daniel, Thompson Douglas, Watts Rheana, Gentry Katherine, Ivanova Iskra, Hetmaniuk Mali, Hsieh Vincent, Collins Michael, Wong Karen, Binstock Wendy, Reid Russell, Poteet-Schwartz Kim, Gries Heike, Hall Rebecca, Koh Jeffrey, Bannister Carolyn, Sung Wai, Jain Ranu, Fernandez Allison, Tuite Gerald F, Ruas Ernesto, Drozhinin Oleg, Tetreault Lisa, Muldowney Bridget, Ricketts Karene, Fernandez Patrick, Sohn Lisa, Hajduk John, Taicher Brad, Burkhart Jessica, Wright Allison, Kugler Jane, Barajas-DeLoa Lea, Gangadharan Meera, Busso Veronica, Stallworth Kayla, Staudt Susan, Labovsky Kristen L, Glover Chris D, Huang Henry, Karlberg-Hippard Helena, Capehart Samantha, Streckfus Cynthia, Nguyen Kim-Phuong T, Manyang Peter, Martinez Jose Luis, Hansen Jennifer K, Levy Heather Mitzel, Brzenski Alyssa, Chiao Franklin, Ingelmo Pablo, Mujallid Razaz, Olutoye Olutoyin A, Syed Tariq, Benzon Hubert, Bosenberg Adrian, Pediatric Craniofacial Collaborative Group
Аннотация
METHODS: Thirty-one institutions contributed data from June 2012 to September 2015. Data extracted included demographics, perioperative management, length of stay, laboratory results, and blood management techniques employed. Complications and outlier events were described. Outcomes analyzed included total blood donor exposures, intraoperative and perioperative transfusion volumes, and length of stay outcomes.
RESULTS: One thousand two hundred twenty-three cases were analyzed: 935 children aged less than or equal to 24 months and 288 children aged more than 24 months. Ninety-five percent of children aged less than or equal to 24 months and 79% of children aged more than 24 months received at least one transfusion. There were no deaths. Notable complications included cardiac arrest, postoperative seizures, unplanned postoperative mechanical ventilation, large-volume transfusion, and unplanned second surgeries. Utilization of blood conservation techniques was highly variable.
CONCLUSIONS: The authors present a comprehensive description of perioperative management, outcomes, and complications from a large group of North American children undergoing complex cranial vault reconstruction. Transfusion remains the rule for the vast majority of patients. The occurrence of numerous significant complications together with large variability in perioperative management and outcomes suggest targets for improvement.