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Economic aspects of intraoperative coagulation management targeting higher fibrinogen concentrations during major craniosynostosis surgery
Author(s) -
Haas Thorsten,
Spielmann Nelly,
Restin Tanja,
Schmidt Alexander R.,
Schmugge Markus,
Cushing Melissa M.
Publication year - 2016
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12784
Subject(s) - medicine , fibrinogen , coagulation , coagulation testing , hemostasis , blood product , fresh frozen plasma , surgery , blood transfusion , anesthesia , craniosynostosis , blood loss , platelet
Summary Background Results of a previously published study demonstrated a significant decrease in transfusion requirements and calculated blood loss for pediatric major craniosynostosis surgery, if a ROTEM ® FIBTEM trigger of <13 mm (early substitution group) was applied as compared to a trigger of <8 mm (conventional group). The aim of this study was a posthoc analysis of the costs for this coagulation management. Methods The total volume as well as the number of units or bags for all transfused blood products and coagulation factors were recorded for each case. The number of laboratory and point‐of‐care coagulation tests was also analyzed. Total blood product costs were calculated according to the local prices per unit. Results The total cost for all transfused/administered blood products/coagulation factors per patient was a median of 1023 EUR ( IQR 850 EUR –1058 EUR ) in the early substitution group as compared to a median of 910 EUR ( IQR 719 EUR –1351 EUR ) in the conventional group ( P = 0.81). No difference in the number of coagulation tests performed was observed. Conclusion In this study, the use of a higher fibrinogen trigger was not linked to a significant increase in total costs for transfused blood products and coagulation factors, and may offer an economically equivalent approach to coagulation management.