Abstract

JULIA, Analía R.; BASILICO, Hugo; MAGALDI, Gustavo  and  DEMIRDJIAN, Graciela. Transfusional requirements for escharectomy in burned children. Arch. argent. pediatr. [online]. 2010, vol.108, n.1, pp.55-60. ISSN 0325-0075.

Introduction. Early excision has considerably improved outcome in extensive burns, but massive resections usually mean copious bleeding that must be conveniently corrected. The purpose of this study was to measure blood component use during escharectomies in children. Material and methods. All pediatric patients with acute burns excised at the Burn Unit of the Hospital Garrahan during one year were included. Volume of blood component used during and immediately after surgery was analyzed and related to percent excised, time post-burn, and the coexistence of infection and autograft at the time of excision. Results. Ninety-four surgeries in 51 children aged 0-14 years with total burned body surface areas of 5-80% who underwent resections of 3-70% were studied. Total blood use (intra + post-operatively) was 2.07 ml/kg/%excised for red blood cells (60% during surgery) and 0.7 ml/kg/% excised for plasma. Only 12% of patients required platelet transfusion. There was no significant requirement variation with the existence of infection, grafting or time post-burn. Conclusions. Approximately 2 ml/kg/% excised of red blood cells (2/3 for surgery) and 1 ml/kg/% excised of plasma are needed for escharectomies in children. The need for platelets must be judged considering the individual patient.

Keywords : Burns; Pediatrics; Escharectomy; Bleeding; Blood components.

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