BLOOD-LOSS DURING REPAIR OF CRANIOSYNOSTOSIS

Surgical repair of craniosynostosis carries a high risk with large blo od losses. Over a 2-yr period, we have managed 115 patients undergoing craniosynostosis repair with peroperative haemodilution to achieve a final PC V of 0. 28-0.35. Measurements of PCV allowed calculation of e stimated blood losses and transfused volumes in terms of red blood cel l mass. Total estimated red cell volume lost was 91 +/- 66% of patient 's estimated red blood cell volume during the peroperative period. The type of skull deformation and surgical procedure determined the exten t of peroperative bleeding. Peroperative transfusion was satisfactory in 48% of patients and slight overtransfusion was noted in 32%. During the postoperative period, liberal administration of blood led to over transfusion and possibly unnecessary transfusion in 74% of patients. B ecause of the well known risks of transmission of infectious disease, strict volume compensation with development of haemodilution and autot ransfusion procedures should be used to limit these risks.