Related Experiment Video
Updated: Dec 20, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Blood Management and Risk Assessment for Transfusion in Pediatric Spinal Deformity Surgery
Pedro Fernandes1, Joaquim Soares do Brito1, Isabel Flores2
1Orthopedic Department, University Hospital of Santa Maria, Lisbon, Portugal.
Insights
A Quality and Safety Program significantly reduced blood loss and transfusion needs in pediatric spinal deformity surgery. This multimodal approach, incorporating risk assessment, improved patient outcomes by minimizing transfusions.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Patient Safety
Background:
- Minimizing blood loss and transfusion is crucial in pediatric spinal deformity surgery.
- Multimodal strategies have shown promise in reducing transfusion rates.
- Anticipating blood loss aids resource allocation and surgical planning.
Purpose of the Study:
- To evaluate the impact of a Quality and Safety Program (QSP) on reducing blood loss and transfusion requirements in pediatric spinal deformity surgery.
- To identify risk factors associated with transfusion needs in this patient population.
Main Methods:
- A single-center retrospective study utilizing prospectively collected data.
- Analysis of patients with idiopathic deformities (Group A) and syndromic/neuromuscular scoliosis (Group B) before and after QSP implementation.
- Comparison of transfusion rates and estimated blood loss between pre- and post-QSP cohorts.
Main Results:
- A significant decrease in transfused patients was observed in both groups post-QSP (Group A: 83.7% to 28%; Group B: 98.7% to 66%).
- Patient body weight and Cobb angle were identified as factors related to blood loss.
- A predictive model indicated body weight and transfusion as significant predictors of hematic losses.
Conclusions:
- A multimodal approach, like the implemented QSP, can substantially reduce transfusion needs in pediatric scoliosis surgery.
- Program success relies on team collaboration and risk assessment tools to guide resource allocation and minimize blood loss.
Objectives:
Evaluate the impact of a Quality and Safety Program (QSP) on the reduction of blood loss and transfusion needs in pediatric spinal deformity surgery, while defining risk factors for transfusion.
Background:
Multimodal plan aiming to minimize transfusion needs has been shown to reduce transfusions and index rates in spinal deformity surgery. Anticipating blood loss and transfusion may help direct resources to patient needs or encourage reconsideration of the surgical plan.
Methods:
This is a single-center retrospective study of prospectively collected data. Impact of this multimodal plan was studied on idiopathic deformities (Group A, 109 patients) and scoliosis associated with syndromic, neuromuscular, and muscular dystrophies (Group B, 100 patients), both before and after QSP.
Results:
A decrease in total estimated blood loss was observed. In Group A, transfused patients decreased from 83.7% to 28% (p < 0.001, odds: 0.077), and, in Group B, from 98.7% to 66% (p < 0.01, odds: 0.038). Pearson's correlation identified patient body weight (r = 0.245, p=0.001) and Cobb angle (r = 0.175, p=0.017) as factors related to blood loss. A linear regression model to estimate hematic losses revealed that only body weight and transfusion showed predictive power, resulting in a low predictive model (R 2 = 0.156; F(3,167) = 15.483, p < 0.001). A mediated model to explain blood loss was built based on a set of variables influencing transfusion which is, in turn, related to blood loss.
Conclusion:
Transfusion needs in scoliosis surgery can be substantially reduced following a multimodal approach. The success of a program is strongly dependent on team effort, and the introduction of a risk assessment tool for transfusion needs indirectly assesses surgical risk, thus allowing relocation of resources to decrease blood loss.
More Related Videos
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:30Venous Thrombosis IV: Nursing Management