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British Journal of Anaesthesia, 1993, Vol. 71, No. 6 854-857
© 1993 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

BLOOD LOSS DURING REPAIR OF CRANIOSYNOSTOSIS

P. MEYER, M.D., D. RENIER, M.D., E. ARNAUD, M.E., M.-M. JARREAU, M.D., B. CHARRON, M.D., E. BUY, M.D., C. BUISSON, M.D. and G. BARRIER, M.D.

Department of Paediatric Anaesthesiology, Hôpital des Enfants Malades 149 rue de Sèvres, 75015 Paris, France
Department of Paediatric Neurosurgery, Hôpital des Enfants Malades 149 rue de Sèvres, 75015 Paris, France

Surgical repair of craniosynostosis carries a high risk with large blood losses. Over a 2-yr period, we have managed 115 patients undergoing cranio synostosis repair with peroperative haemodllution to achieve a final PCV of 0.28–0.35. Measurements of PCV allowed calculation of estimated blood losses and transfused volumes in terms of red blood cell mass. Total estimated red cell volume lost was 91±66+ of patient's estimated red blood cell volume during the peroperative period. The type of skull deformation and surgical procedure deter mined the extent of peroperative bleeding. Peroperative transfusion was satisfactory in 48% of patients and slight overtransfusion was noted in 32%. During the postoperative period, liberal administration of blood led to overtransfusion and possibly unnecessary transfusion in 74% of patients. Because of the well known risks of transmission of infectious disease, strict volume compensation with development of haemodilution and autotransfusion procedures should be used to limit these risks. (Br. J. Anaesth. 1993; 71 : 854–857)


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