| Title |
Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction
|
|---|---|
| Published in |
Anesthesiology, February 2017
|
| DOI | 10.1097/aln.0000000000001481 |
| Pubmed ID | |
| Authors |
Paul A. Stricker, Susan M. Goobie, Franklyn P. Cladis, Charles M. Haberkern, Petra M. Meier, Srijaya K. Reddy, Thanh T. Nguyen, Lingyu Cai, Marcia Polansky, Peter Szmuk, John Fiadjoe, Codruta Soneru, Ricardo Falcon, Timothy Petersen, Courtney Kowalczyk-Derderian, Nicholas Dalesio, Stefan Budac, Neels Groenewald, Daniel Rubens, Douglas Thompson, Rheana Watts, Katherine Gentry, Iskra Ivanova, Mali Hetmaniuk, Vincent Hsieh, Michael Collins, Karen Wong, Wendy Binstock, Russell Reid, Kim Poteet-Schwartz, Heike Gries, Rebecca Hall, Jeffrey Koh, Carolyn Bannister, Wai Sung, Ranu Jain, Allison Fernandez, Gerald F. Tuite, Ernesto Ruas, Oleg Drozhinin, Lisa Tetreault, Bridget Muldowney, Karene Ricketts, Patrick Fernandez, Lisa Sohn, John Hajduk, Brad Taicher, Jessica Burkhart, Allison Wright, Jane Kugler, Lea Barajas-DeLoa, Meera Gangadharan, Veronica Busso, Kayla Stallworth, Susan Staudt, Kristen L. Labovsky, Chris D. Glover, Henry Huang, Helena Karlberg-Hippard, Samantha Capehart, Cynthia Streckfus, Kim-Phuong T. Nguyen, Peter Manyang, Jose Luis Martinez, Jennifer K. Hansen, Heather Mitzel Levy, Alyssa Brzenski, Franklin Chiao, Pablo Ingelmo, Razaz Mujallid, Olutoyin A. Olutoye, Tariq Syed, Hubert Benzon, Adrian Bosenberg |
| Abstract |
The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices. 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. 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. 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. |
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X Demographics
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 60% |
| Mexico | 1 | 10% |
| Unknown | 3 | 30% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 4 | 40% |
| Members of the public | 4 | 40% |
| Practitioners (doctors, other healthcare professionals) | 2 | 20% |
Mendeley readers
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 73 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 14% |
| Researcher | 9 | 12% |
| Student > Bachelor | 8 | 11% |
| Professor > Associate Professor | 5 | 7% |
| Student > Postgraduate | 5 | 7% |
| Other | 14 | 19% |
| Unknown | 22 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 40 | 55% |
| Neuroscience | 3 | 4% |
| Agricultural and Biological Sciences | 2 | 3% |
| Arts and Humanities | 1 | 1% |
| Biochemistry, Genetics and Molecular Biology | 1 | 1% |
| Other | 3 | 4% |
| Unknown | 23 | 32% |