Key result
Preoperative evaluation and protocol-based blood management are recommended for pediatric patients undergoing major surgery to effectively manage blood loss and achieve early hemostasis.
Highlights the importance of preoperative full blood count evaluation and protocol-based transfusion management in pediatric surgical patients.
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Pre-operative anemia correction and MABL calculation may guide transfusion in pediatric surgery; leaves open prospective validation of protocols.
Paediatric patients undergoing surgical procedures commonly require some volume of blood or blood component replacement in the perioperative period. Paediatric patients undergoing major surgery associated with substantial blood loss should be evaluated pre-operatively. Pre-operative correction of anaemia may be done considering the age, plasma volume status, clinical status and comorbidities. Maximum allowable blood loss (MABL) for surgery must be calculated, and appropriate quantity of blood and blood components should be arranged. Intraoperative monitoring of blood loss should be done, and volume of transfusion should be calculated in a protocol based manner considering the volemia and the trigger threshold for transfusion for the patient and the MABL. Early haemostasis should be achieved by judicious administration of red blood cells, blood components and pharmacological agents.
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Hamouda et al. (2019) conducted a review in Pediatric patients undergoing surgeries. Preoperative full blood count and blood management was evaluated. Preoperative evaluation and protocol-based blood management are recommended for pediatric patients undergoing major surgery to effectively manage blood loss and achieve early hemostasis.
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