Massive blood transfusion in choroid plexus tumor surgery: 10-years' experience

J Clin Anesth. 2007 May;19(3):192-7. doi: 10.1016/j.jclinane.2006.10.010.

Abstract

Study objective: To describe our 10 years of experience with childhood choroid plexus tumors (CPTs).

Design: Retrospective chart analysis.

Setting: Operating room and pediatric intensive care unit (PICU) of a university hospital.

Patients: 18 infants and children undergoing CPT surgery from 1995 to 2004, 11 of whom were younger than 12 months.

Measurements: Perioperative hematologic and coagulation data were measured as well as estimated red cell volume variations (as a reliable index of blood loss) in the perioperative period, together with coagulation parameters.

Results: Greater blood loss was recorded in the infant group vs older children (percentage of estimated red cell volume loss, 1.31 +/- 1.79% vs 0.20 +/- 0.17% [P < 0.01] and 1.50 +/- 1.86% vs 0.29 +/- 0.21% [P < 0.01] on PICU admission and after 72 hours, respectively). Platelet count decrease was similarly noted (51.60 +/- 28.06 vs 27.57 +/- 11.98, P < 0.05, as percentage of preoperative count). Patients operated on in the neonatal period showed the highest blood loss and related coagulation impairment.

Conclusion: Younger CPT surgery patients present an increased risk versus their older counterparts of massive bleeding resulting in hemodynamic instability and coagulative impairment.

MeSH terms

  • Anesthesia, General
  • Biomedical Research
  • Blood Loss, Surgical*
  • Blood Transfusion*
  • Child, Preschool
  • Choroid Plexus Neoplasms / blood
  • Choroid Plexus Neoplasms / surgery*
  • Female
  • Hemostasis, Surgical
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Monitoring, Physiologic
  • Outcome Assessment, Health Care
  • Perioperative Care
  • Retrospective Studies
  • Statistics, Nonparametric