{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:17Z","timestamp":1787015837426,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antifibrinolytics such as tranexamic acid and epsilon\u2010aminocaproic acid are effective at reducing blood loss and transfusion in pediatric patients having craniofacial surgery. The Pediatric Craniofacial Collaborative Group has previously reported low rates of seizures and thromboembolic events (equal to no antifibrinolytic given) in open craniofacial surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To query the Pediatric Craniofacial Collaborative Group database to provide an updated antifibrinolytic safety profile in children given that antifibrinolytics have become recommended standard of care in this surgical population. Additionally, we include the population of younger infants having minimally invasive procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients in the Pediatric Craniofacial Collaborative Group registry between June 2012 and March 2021 having open craniofacial surgery (fronto\u2010orbital advancement, mid and posterior vault, total cranial vault remodeling, intracranial LeFort III monobloc), endoscopic cranial suture release, and spring mediated cranioplasty were included. The primary outcome is the rate of postoperative complications possibly attributable to antifibrinolytic use (seizures, seizure\u2010like activity, and thromboembolic events) in infants and children undergoing craniosynostosis surgery who did or did not receive antifibrinolytics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five institutions reporting 6583 patients were included. The overall seizure rate was 0.24% (95% CI: 0.14, 0.39%), with 0.20% in the no Antifibrinolytic group and 0.26% in the combined Antifibrinolytic group, with no statistically reported difference. Comparing seizure rates between tranexamic acid (0.22%) and epsilon\u2010aminocaproic acid (0.44%), there was no statistically significant difference (odds ratio\u00a0=\u00a02.0; 95% CI: 0.6, 6.7;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.257). Seizure rate was higher in patients greater than 6\u2009months (0.30% vs. 0.18%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.327), patients undergoing open procedures (0.30% vs. 0.06%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.141), and syndromic patients (0.70% vs. 0.19%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This multicenter international experience of pediatric craniofacial surgery reports no increase in seizures or thromboembolic events in those that received antifibrinolytics (tranexamic acid and epsilon\u2010aminocaproic acid) versus those that did not. This report provides further evidence of antifibrinolytic safety. We recommend following pharmacokinetic\u2010based dosing guidelines for administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pan.14540","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T13:04:20Z","timestamp":1659618260000},"page":"1339-1346","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Safety of antifibrinolytics in 6583 pediatric patients having craniosynostosis surgery: A decade of data reported from the multicenter Pediatric Craniofacial Collaborative Group"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6147-8804","authenticated-orcid":false,"given":"Michael R.","family":"King","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7588-7596","authenticated-orcid":false,"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5012-8035","authenticated-orcid":false,"given":"Paul A.","family":"Stricker","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0057-1930","authenticated-orcid":false,"given":"Carolina","family":"P\u00e9rez\u2010Pradilla","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2930-138X","authenticated-orcid":false,"given":"Olivia","family":"Nelson","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-4410","authenticated-orcid":false,"given":"Hubert A.","family":"Benzon","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Ann and Robert H. 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