Updates in perioperative hemostasis in the pediatric surgical patient

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Hematology

Background:

• Pediatric perioperative bleeding and hemostasis management present unique challenges.
• Patient blood management (PBM) programs are crucial for optimizing outcomes.

Purpose of the Study:

• To review recent updates in pediatric perioperative bleeding and hemostasis management.
• To highlight advancements in patient blood management strategies for pediatric surgical patients.

Main Methods:

• Literature review of recent evidence on pediatric PBM.
• Analysis of studies on restrictive transfusion thresholds and allogeneic blood product reduction.
• Evaluation of viscoelastic testing and whole blood use in pediatric populations.

Main Results:

• Growing evidence supports restrictive transfusion thresholds and reduced allogeneic blood use in children.
• Pediatric PBM programs show promise in treating anemia and optimizing coagulation.
• Viscoelastic testing and whole blood show efficacy in pediatric settings.

Conclusions:

• Patient blood management components, including anemia treatment and restrictive transfusion, are increasingly adopted in pediatric care.
• Further evidence is required to guide anesthesiologists in pediatric hemostasis management.
• Optimizing coagulation and tolerating physiologic anemia are key PBM strategies.