How frequent is homologous blood transfusion during pediatric adenoidectomy and tonsillectomy?

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Adekola, O. O
Akanmu, N. O
Bamigboye, B. A
Akinola, M. D
Adedolapo, H. L
Dada, O. I. O
Somefun, A. O
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Woltlers Kluwer
Background: Blood is routinely grouped and cross matched for elective adenoidectomy and, or, tonsillectomy at our institution. This practice has led to unnecessary delay and cancellation of surgery. Materials and Methods: This was a prospective study conducted in children aged one and half to nine years scheduled for adenoidectomy and, or, tonsillectomy from January, 2012 to April 2013. We investigated the need for routine preoperative grouping and cross matching of blood, and the immediate complications following adenotonsillectomy. Data collected included the number of blood cross matched and transfused, pre- and postoperative haemoglobin, estimated blood loss, duration of delay in commencing surgery due to lack of blood and the immediate complications following adenoidectomy and tonsillectomy. Results: A total of 129 patients were studied, adenotonsillectomy was performed in 88.37%, adenoidectomy in 7.75%, and tonsillectomy in 3.88%. The median estimated blood loss was 100 IQR (60-100 ml), 145 pints of blood were requested in all, one pint in 77.93% and two pints in 22.07%. The Cross-match to Transfusion Ratio, Transfusion Index and Blood ordering quotient were zero (0) respectively. The median duration of delay before surgery commenced on account of lack of blood was 84 IQR (27.5-119.5) mls. Primary haemorrhage was observed in 4 (3.1%), accidental extubation in 13 (10.07%), hypoxia 5 (3.88%) and cardiac arrest in one patient (0.78%). Conclusion: The cross-match to transfusion ratio, transfusion index and blood ordering quotient were zero, which suggest that cross-matched blood is unlikely to be required, and there was low blood usage. Therefore, the routine practice of preoperative grouping and cross matching of blood seems unnecessary adenoidectomy and, or, tonsillectomy. It is recommended that group and save should be encouraged because of shortage of blood in our country.
Scholarly article
Adenotonsillectomy , Blood transfusion , tonsillectomy , Complications , Research Subject Categories::MEDICINE::Surgery::Anaesthetics and intensive care
Adekola OO, Akanmu ON, Bamigboye BA, Akinnola MD, Adedolapo HL, Dada OI, et al. How frequent is homologous blood transfusion during pediatric adenoidectomy and tonsillectomy?. J Clin Sci 2016;13:187-92.