<< Back to the abstract archive
Multi-disciplinary blood ordering protocol for patients undergoing surgical cranial vault remodeling
Navid Pourtaheri, MD, PhD, Hollie Reeves, Jamal Nofal, Anne Capetillo, Maura Berkelhamer, Katharine Downes, Gregory Lakin, MD
Case Western Reserve University, Department of Plastic Surgery
2016-02-01
Presenter: Navid Pourtaheri, MD, PhD
Affidavit:
100% of this work reflects the efforts of Navid Pourtaheri under the supervision by his mentor Greogroy Lakin, MD.
Director Name: Hooman Soltanian, MD, FACS
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: While blood transfusion is common in surgical cranial vault remodeling (SCVR) no standard exists regarding transfusion practice. A multidisciplinary team was assembled to create a blood ordering protocol to decrease the Red Blood Cell (RBC) issue and transfusion times for patients undergoing SCVR at our institution.
Methods: A retrospective review was performed using clinical charts, operative notes, anesthesia records, and blood bank data on all patients who received SCVR from September 2012 through March 2015. We analyzed patient demographics, complications, transfusion reactions, RBC issue time, incision time, RBC transfusion times, and protocol enrollment. Patients within the protocol had a blood type and crossmatch sample sent within 21 days before surgery. A second ABO verification sample, if necessary, was sent the morning of surgery to allow for transfusion of type-specific RBC.
Results: Over a 31 month period, 24 children (42% female, 58% male) with mean age of 17 months (range 5.5 – 105.7) underwent SCVR; 12 (50%) underwent SCVR before protocol implementation and 12 after. Mean in-room to incision time before vs. after protocol implementation was similar (109.5 vs. 111.3 minutes, p=0.8796). Mean RBC issue time was improved by 96 minutes (842 vs. 746 minutes, p=0.0139). In-room to RBC infusion time was improved by 60 minutes (182.3 vs. 122.8 minutes, p=0.0146). All patients were transfused RBCs and there were no complications or transfusion reactions.
Conclusions: A multidisciplinary blood ordering protocol can safely optimize patient care and blood transfusion times in complex surgical cases.
