Abstract: Striving for Transfusion-Free Open Cranial Vault Remodeling: A Novel Protocol

METHODS: Forty-one consecutive patients undergoing open cranial vault remodeling were retrospectively reviewed. Early in the series, individual anesthesiologist preference dictated aminocaproic acid (ACA) use, and no patients received erythropoietin (EPO). After protocol initiation, all patients were evaluated for EPO and all patients received intraoperative ACA. Transfusion guidelines were defined. Cell Saver device was used when possible. Comparisons were made between the new protocol “ACA+EPO Group” (received ACA, received EPO), the pre-protocol “ACA Only Group” (received ACA, did not receive EPO), and the pre-protocol “No ACA Group” (did not receive ACA, did not receive EPO). Tukey’s HSD Test was used to compare groups on patient characteristics, estimated blood loss (EBL), and allogeneic packed red blood cell transfusion volume.