Analysis of perioperative blood management in 23 RhD-negative children undergoing neurosurgery
Objective Retrospective analysis of perioperative blood management in RhD-negative children undergoing neurosurgery,and analysis of the characteristics of management of such children to improve clinical prognosis and safety.Methods We retrospectively collected the medical records of RhD-negative children who underwent intracranial occupancy resection from 2015 to 2022 and analyzed demographic information,laboratory test results,blood preparation and transfusion-related perioperative blood management.Results Twenty-three RhD-negative children were included in the analysis.The average age of the children was(7±3.5)years old,preoperative preparation of allogeneic blood was requested in 22 cases(95.7%),17 cases(73.9%)were successful and 5 cases(21.7%)were unsuccessful in preoperative blood preparation,the time between requesting blood preparation and surgery was(5.8±3)d,and 260(260,455)mL of allogeneic red blood cells were prepared,of which 1 case(4.3%)had 400 mL of preoperative autologous stored whole blood.Intraoperative bleeding was 4.8(2.2,13.3)mL/kg.Of the 10 blood transfusions,7(30.4%)were transfused with allogeneic red blood cells only,1(4.3%)was transfused with allogeneic red blood cells and autologous red blood cells,1(4.3%)was transfused with autologous red blood cells,and 1 case(4.3%)was transfused with 150 mL of stored whole blood.The transfusion rate was 43.5%,with the crossmatch to transfusion(C/T)ratio of 2.7,and transfusion index(Ti)of 1.Intraoperative arterial blood gas analysis was performed in 12(52.2%)cases,thromboelastography was monitored in 2(8.7%)cases.Postoperative hemoglobin was(117±19.4)g/L.Mild anemia was observed in 6(26.1%)cases,and moderate anemia was observed in 2(8.7%)cases after surgery.Conclusions It is necessary to formulate a blood transfusion plan and reasonable perioperative blood management according to the type and location of the child's lesion and adopt a multimodal treatment strategy to reduce bleeding and the dependence on allogeneic RhD-negative blood to ensure the safety of the child's surgery.
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