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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
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Preoperative Transfusion in Sickle Cell Disease Children Undergoing Adenotonsillectomy
Sonika Kanotra1, Samuel H Muller2, Jhanvi Kanotra3
1Department of ENT, Government Medical College, Jammu, India.
Summary
For children with sickle cell disease undergoing adenotonsillectomy, an aggressive transfusion regimen is not more effective than a conservative one in preventing post-operative complications. A conservative approach is recommended to minimize transfusion risks.
Area of Science:
- Pediatric Hematology
- Surgical Oncology
- Transfusion Medicine
Background:
- Sickle cell disease (SCD) patients undergoing adenotonsillectomy face risks of post-operative complications.
- Pre-operative transfusion strategies aim to mitigate these risks, with debated efficacy between conservative and aggressive approaches.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of conservative versus aggressive pre-operative transfusion regimens in pediatric SCD patients undergoing adenotonsillectomy.
- To compare post-operative complications, SCD-related events, and transfusion-related complications between the two regimens.
Main Methods:
- A comprehensive literature search was conducted across PubMed, EMBASE, Cochrane, and Ovid databases.
- Seven articles were selected for systematic review, and two controlled trials were included in the meta-analysis based on predefined criteria.
Main Results:
- No statistically significant difference was found in primary/secondary hemorrhage rates between aggressive and conservative transfusion groups (p=0.089).
- SCD-related complications (vaso-occlusive crisis, acute chest syndrome) also showed no significant difference (p=0.339).
- While not statistically significant, the aggressive transfusion group exhibited a higher rate of transfusion-related complications.
Conclusions:
- Aggressive transfusion regimens (HbS <30%) do not offer superior protection against post-operative complications in pediatric SCD patients undergoing adenotonsillectomy compared to conservative regimens.
- A conservative transfusion strategy is advisable to reduce the overall risk of transfusion-associated complications.
Keywords:
AdenoidectomyAdenotonsillectomyBleedingChildrenPediatricSickle cell diseaseSystematic reviewTonsilTonsillectomyTransfusionMore Related Videos
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