Title

Perioperative Blood Management in Pediatric Spine Surgery

Document Type

Journal Article

Publication Date

7-1-2017

Journal

Journal of the American Academy of Orthopaedic Surgeons

Volume

25

Issue

7

DOI

10.5435/JAAOS-D-16-00035

Keywords

blood management; blood transfusion; pediatrics; scoliosis; spine surgery

Abstract

© Copyright 2017 by the American Academy of Orthopaedic Surgeons. Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood. Guidelines can also help manage allogeneic transfusions in the perioperative period. Although the literature on blood management has focused primarily on arthroplasty and adult spine surgery, pediatric spinal fusion for scoliosis involves a large group of patients with a specific set of risk factors for transfusion and distinct perioperative considerations. A thorough understanding of blood management techniques will improve surgical planning, limit transfusion-associated risks, maintain hemostasis, and optimize outcomes in this pediatric population.

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