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Minerva Orthopedics 2021 June;72(3):290-301

DOI: 10.23736/S2784-8469.20.04050-3


lingua: Inglese

Blood loss management in pediatric spinal surgery for scoliosis

Flavio BECCHETTI 1 , Luigi A. NASTO 1, Svetlana KOTZEVA 2

1 Unit of Orthopedics and Traumatology, IRCCS Gaslini, Genoa, Italy; 2 Unit of Anesthesia and Intensive Care, IRCCS Gaslini, Genoa, Italy

Blood transfusion related to pediatric spinal surgery is a relevant aspect of the perioperatory period that can affect the patient both from a clinical point of view, growing mortality and morbidity effect, and the health system from an economical point of view. Better strategies for management of blood loss and blood transfusion are needed. We reviewed the literature of the last ten years and we found that there are many aspects to consider in the management of blood loss. We divided the option available in perioperative, intraoperative and postoperative periods. We considered anesthesiologic and surgery options. Many authors studied the blood loss management in case of spinal surgery, each of them among their field of interest: surgical or anesthesiologic. There are many advices to follow in every step of the preparation of a patient for surgery, in the intraoperative or postoperative period. The medical therapy is the most important aspect in the preoperative and postoperative period, while surgical techniques in the intraoperative period. However, only with the integration of the different options available, surgical or anesthesiologic, it is possible to achieve a noticeable reduction of total blood loss in pediatric patients undergoing spinal surgery. Using every option available in the effort of limiting blood loss in occasion of pediatric spine surgery, lead to less use of blood transfusion; thus, leading to a lowering in clinical complication and morbidity. Reducing the need of blood transfusion affect the expenses for the national health system as well.

KEY WORDS: Scoliosis; Surgical procedures, operative; Blood transfusion

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