{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:27:46Z","timestamp":1782973666515,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,1,13]],"date-time":"2014-01-13T00:00:00Z","timestamp":1389571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Moderate to severe intraoperative bleeding and the presence of acquired coagulopathy remain serious problems in the management of major pediatric craniosynostosis surgery. After implementation of a <jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content><jats:sup>\u00ae<\/jats:sup>\u2010assisted patient blood management (<jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content>) strategy, using primarily purified coagulation factor concentrates, feasibility and costs of this new regimen were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of all consecutive children who underwent primary elective major craniofacial surgery for craniosynostosis repair was carried out at the Children's University Hospital, <jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>urich, between 2007 and 2013. Laboratory workup and transfusion requirements were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 47 children (36 in the historic group and 11 after implementation of <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content>) were analyzed. Although all patients in this study needed transfusion of red blood cell concentrates, there was a total avoidance of perioperative transfusion of fresh frozen plasma and a reduction in transfused platelets (one of nine children vs nine of 36 children in the historic group) after implementation of the <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> strategy. Based on a predefined <jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content><jats:sup>\u00ae<\/jats:sup> threshold in the <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> group (Fib<jats:styled-content style=\"fixed-case\">TEM MCF<\/jats:styled-content> &lt;8\u00a0mm), administration of fibrinogen concentrate was necessary in all of these children. The mean total costs per patient consisting of transfused allogeneic blood products and coagulation factor concentrates were reduced by 17.1% after implementation of <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> (1071.82 <jats:styled-content style=\"fixed-case\">EUR<\/jats:styled-content> per patient before vs 888.93 <jats:styled-content style=\"fixed-case\">EUR<\/jats:styled-content> after implementation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The implementation of a <jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content><jats:sup>\u00ae<\/jats:sup>\u2010assisted <jats:styled-content style=\"fixed-case\">PBM<\/jats:styled-content> is feasible and is associated with a considerable reduction in intraoperative transfusion requirements and thereby a decrease in transfusion\u2010related direct costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12341","type":"journal-article","created":{"date-parts":[[2014,1,13]],"date-time":"2014-01-13T09:12:45Z","timestamp":1389604365000},"page":"774-780","source":"Crossref","is-referenced-by-count":78,"title":["Improvements in patient blood management for pediatric craniosynostosis surgery using a <scp>ROTEM<\/scp><sup>\u00ae<\/sup>\u2010assisted strategy \u2013 feasibility and costs"],"prefix":"10.1111","volume":"24","author":[{"given":"Thorsten","family":"Haas","sequence":"first","affiliation":[{"name":"Department of Anaesthesia University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Goobie","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Peri\u2010operative &amp; Pain Medicine Boston Children's Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Spielmann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schmugge","sequence":"additional","affiliation":[{"name":"Department of Haematology University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318204649a"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03227.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03689.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03474.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e318219291c"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2009.11.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03470.x"},{"key":"e_1_2_9_9_1","unstructured":"World Health Organization.Sixty\u2010third World Health Assembly WHA63\/2010\/REC\/1 Resolutions and decisions 2010. 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