{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:20:36Z","timestamp":1754486436268},"reference-count":74,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2012,5]]},"abstract":"\nObject<\/jats:title>\nControlled hypotension is routinely used during open repair of craniosynostosis to decrease blood loss, although this benefit is unproven. In this study the authors analyzed the longitudinal relationships between intraoperative mean arterial pressure (MAP) and calculated blood loss (CBL) during frontoorbital advancement (FOA) for craniosynostosis.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe authors reviewed the records of infants with craniosynostosis who had undergone primary FOA between 1997 and 2009. Anesthesia records provided preoperative and serial intraoperative MAP. Interval measures of CBL had been determined during the course of the operation. The longitudinal relationships between MAPmean<\/jats:sub>, MAPchange<\/jats:sub>, and CBLchange<\/jats:sub> were assessed over the same time interval and compared between adjacent time intervals to determine the directionality of associations.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nNinety infants (44 males and 46 females) underwent FOA at a mean age and weight of 10.7 \u00b1 12.9 months and 9.0 \u00b1 7.0 kg, respectively. The average intraoperative MAP was 56.1 \u00b1 4.8 mm Hg, 22.6 \u00b1 12.1% lower than preoperative baseline. A negative correlation was found between CBLchange<\/jats:sub> and MAPmean<\/jats:sub> over the same interval (r = \u22120.31, p < 0.05), and an inverse relationship was noted between CBLchange<\/jats:sub> of the previous interval and MAPchange<\/jats:sub> of the next interval (r = \u22120.07, p < 0.05). Finally, there was no significant association between MAPchange<\/jats:sub> of the previous interval and CBLchange<\/jats:sub> of the next interval.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nCalculated blood loss demonstrated a negative correlation with MAP during FOA. Directionality testing indicated that MAP did not affect intraoperative blood loss; instead, blood loss drove changes in MAP. Overall, these findings challenge the benefit of controlled hypotension during open craniofacial repair.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.1.peds11459","type":"journal-article","created":{"date-parts":[[2012,4,30]],"date-time":"2012-04-30T15:27:39Z","timestamp":1335799659000},"page":"491-496","source":"Crossref","is-referenced-by-count":9,"title":["Controlled hypotension and blood loss during frontoorbital advancement"],"prefix":"10.3171","volume":"9","author":[{"given":"Mitchel","family":"Seruya","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Georgetown University Hospital; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert K.","family":"Oh","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary F.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive 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