Journal article
Preoperative Transfusion in Sickle Cell Disease Children Undergoing Adenotonsillectomy
Indian journal of otolaryngology, and head, and neck surgery, Vol.75(2), pp.227-235
06/2023
DOI: 10.1007/s12070-022-03137-7
PMCID: PMC10235364
PMID: 37275080
Abstract
Objective To perform a systematic review and meta-analysis comparing two pre-operative transfusion regimens (conservative versus aggressive) in children with sickle cell disease(SCD) undergoing adenotonsillectomy in terms of post-operative complications, complications related to SCD and transfusion related complications. Data Sources and Review Methods A literature review was performed through PubMed, EMBASE, Cochrane, and Ovid databases using the following phrases: (Adenotonsillectomy OR Tonsillectomy) AND (Sickle Cell Disease OR Sickle Cell Trait). Using predetermined inclusion and exclusion criteria, seven articles were selected for systemic review and two control trials were included in meta-analysis. Results Out of a total of 3,146 results, seven articles were selected for review and two controlled trials were included in the meta-analysis. There was no statistically significant difference in the rate of primary and secondary hemorrhage between the aggressive and conservative transfusion regimens (RR = 3.1, CI = 0.84-11.4, p-value = 0.089). The rate of sickle cell disease related complications including vaso-occlusive crisis and acute chest syndrome was also not statistically significant between the two transfusion groups (RR = 1.4, CI = 0.7-2.8, p-value = 0.339). Even though, the transfusion related complications did not reach statistical significance, there was a higher complication rate in the group receiving aggressive blood transfusion. Conclusion In SCD children undergoing adenotonsillectomy, an aggressive transfusion regimen that focuses on reducing the Hemoglobin S ratio to below 30% has not been shown to be more effective in reducing post-operative complications when compared to a conservative transfusion regimen. Therefore, it is reasonable to utilize a conservative transfusion regimen, thereby reducing the transfusion-associated risks.
Details
- Title: Subtitle
- Preoperative Transfusion in Sickle Cell Disease Children Undergoing Adenotonsillectomy
- Creators
- Sonika Kanotra - Government Medical CollegeSamuel H. Muller - Wake Forest Baptist Hosp, Dept Anesthesiol, Winston Salem, NC USAJhanvi Kanotra - University of IowaRenee Gardner - Childrens Hosp New Orleans, Dept Pediat, Div Hematol Oncol, New Orleans, LA USASohit Paul Kanotra - Univ Iowa Hosp & Clin, Dept Otolaryngol, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Indian journal of otolaryngology, and head, and neck surgery, Vol.75(2), pp.227-235
- DOI
- 10.1007/s12070-022-03137-7
- PMID
- 37275080
- PMCID
- PMC10235364
- NLM abbreviation
- Indian J Otolaryngol Head Neck Surg
- ISSN
- 2231-3796
- eISSN
- 0973-7707
- Publisher
- Springer Nature
- Number of pages
- 9
- Language
- English
- Electronic publication date
- 09/09/2022
- Date published
- 06/2023
- Academic Unit
- Stead Family Department of Pediatrics; Pathology; Otolaryngology
- Record Identifier
- 9984311444802771
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