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  1. Article ; Online: Reply to: Steinbok P (2019) Letter to the Editor Re: Escher PJ, Tu A, Kearney S, Wheelwright M, Petronio J, Kebriaei M, Chinnadurai S, Tibesar RJ (2019) Minimizing transfusion in sagittal craniosynostosis surgery: the Children's Hospital of Minnesota Protocol. Childs Nerv Syst. 2019 Aug;35(8):1357-1362.

    Escher, Paul J / Tu, Albert / Tibesar, Robert J

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2019  Volume 36, Issue 1, Page(s) 5

    MeSH term(s) Blood Transfusion ; Child ; Craniosynostoses ; Facial Bones ; Hospitals, Pediatric ; Humans ; Minnesota
    Language English
    Publishing date 2019-11-26
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-019-04424-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2036: Show issues Location:
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  2. Article ; Online: Malnutrition as a Risk Factor in Cleft Lip and Palate Surgery.

    Escher, Paul J / Zavala, Hanan / Lee, Daniel / Roby, Brianne Barnett / Chinnadurai, Sivakumar

    The Laryngoscope

    2020  Volume 131, Issue 6, Page(s) E2060–E2065

    Abstract: Objectives/hypothesis: To assess the prevalence of acute and chronic malnutrition at the time of surgery in patients with cleft lip and/or palate (CLP) at our institution, and to quantify nutrition as a risk factor for postsurgical complications ... ...

    Abstract Objectives/hypothesis: To assess the prevalence of acute and chronic malnutrition at the time of surgery in patients with cleft lip and/or palate (CLP) at our institution, and to quantify nutrition as a risk factor for postsurgical complications following CLP surgery.
    Study design: Retrospective cohort study.
    Methods: Retrospective review of 855 children undergoing initial cleft lip or palate surgery, or revision surgery after fistula/dehiscence of initial cleft repair. We measured acute and chronic malnutrition using World Health Organization Z-scores of weight-for-age and height-for-age, respectively, and noted any postsurgical fistula or dehiscence.
    Results: Among patients with cleft lip, 22.3% were at least moderately chronically malnourished at the time of initial repair, and 17.5% were at least moderately acutely malnourished. Among patients undergoing initial repair of cleft palate, 20.9% were at least moderately chronically malnourished, and 8.1% were at least moderately acutely malnourished. Increasing nutritional status, as measured by height-for-age, predicts decreased odds of fistula (OR 0.78, P = .01) after cleft palate surgery.
    Conclusions: Chronic malnutrition significantly increases the risk of fistula formation in patient with cleft palate. Preoperative strategies to manage this risk and influence surgical timing can avoid morbid and costly postoperative complications.
    Level of evidence: 4 Laryngoscope, 131:E2060-E2065, 2021.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cleft Lip/surgery ; Cleft Palate/surgery ; Female ; Humans ; Male ; Malnutrition/epidemiology ; Middle Aged ; Postoperative Complications/epidemiology ; Prevalence ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2020-11-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.29209
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  3. Article ; Online: Demographic Risk Factors for Malnutrition in Patients With Cleft Lip and Palate.

    Taufique, Zahrah M / Escher, Paul J / Gathman, Tyler J / Nickel, Amanda J / Lee, Daniel B / Roby, Brianne B / Chinnadurai, Sivakumar

    The Laryngoscope

    2021  Volume 132, Issue 7, Page(s) 1482–1486

    Abstract: Objectives/hypothesis: Patients with cleft lip and/or palate (CLP) are at increased risk of malnutrition. Acute and chronic malnutrition have been associated with elevated risk of postsurgical wound complications, adding morbidity and cost to patients ... ...

    Abstract Objectives/hypothesis: Patients with cleft lip and/or palate (CLP) are at increased risk of malnutrition. Acute and chronic malnutrition have been associated with elevated risk of postsurgical wound complications, adding morbidity and cost to patients and their families. To study the association between demographic factors, including insurance type, race, and median neighborhood income (MNI), and malnutrition in patients with CLP.
    Study design: Retrospective cohort study.
    Methods: Retrospective review was performed in patients undergoing their first cleft-related surgery at a large tertiary pediatric hospital from 2006 to 2018. Demographic data, weight and height at surgery, type of insurance, race, and primary residential address were collected. Geocoded information on MNI was generated using patient address. World Health Organization Z-scores for weight-for-age (WFA) and height-for-age (HFA) were used as proxies for acute and chronic malnutrition, respectively. Linear regression models were generated to analyze the relationship of insurance type, race, and MNI on WFA and HFA Z-scores.
    Results: About 313 patients met inclusion criteria. Increasing MNI predicted increasing WFA Z-score (0.05 increase in WFA per $1,000 increase, P = .047) as well as HFA Z-score (0.09 increase in HFA per $1,000 increase, P = .011). The effect of MNI was not independently modified by race for either WFA (P = .841) nor HFA (P = .404). Race and insurance type did not predict WFA or HFA.
    Conclusions: Lower MNI is a significant independent risk factor for acute and chronic malnutrition in children with CLP. Combined with previous investigation linking malnutrition to surgical outcomes in this population, this offers a target area for intervention to improve patient outcomes.
    Level of evidence: 3 Laryngoscope, 132:1482-1486, 2022.
    MeSH term(s) Child ; Cleft Lip/complications ; Cleft Lip/epidemiology ; Cleft Lip/surgery ; Cleft Palate/complications ; Cleft Palate/surgery ; Demography ; Humans ; Malnutrition/complications ; Malnutrition/epidemiology ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2021-10-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.29899
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  4. Article ; Online: A protocol of situation-dependent transfusion, erythropoietin and tranexamic acid reduces transfusion in fronto-orbital advancement for metopic and coronal craniosynostosis.

    Escher, Paul J / Tu, Albert D / Kearney, Susan L / Linabery, Amy M / Petronio, Joseph A / Kebriaei, Meysam A / Chinnadurai, Sivakumar / Tibesar, Robert J

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2020  Volume 37, Issue 1, Page(s) 269–276

    Abstract: Purpose: Assess the effect of a protocol of preoperative erythropoietin (EPO) and ferrous sulfate in addition to perioperative tranexamic acid (TXA) on blood transfusions in patients with coronal or metopic craniosynostosis undergoing cranial vault ... ...

    Abstract Purpose: Assess the effect of a protocol of preoperative erythropoietin (EPO) and ferrous sulfate in addition to perioperative tranexamic acid (TXA) on blood transfusions in patients with coronal or metopic craniosynostosis undergoing cranial vault remodeling (CVR) with fronto-orbital advancement (FOA).
    Methods: Retrospective review of all coronal and metopic craniosynostosis patients undergoing CVR and FOA from March 2010 to June 2019 was performed. Before 2014 ("Control group"), all patients received blood transfusion at the start of surgery. In 2014, a protocol of preoperative EPO and ferrous sulfate with perioperative TXA and non-automatic transfusion was instituted ("Study group"). Patient demographics and anthropometrics, perioperative hemoglobin (Hb) levels, and transfusion details were collected and compared.
    Results: Thirty-six patients met inclusion criteria. Twenty-one patients were in the control group, and 15 in the Study group. Nineteen patients had metopic synostosis, 11 had unicoronal synostosis, and 6 had bicoronal synostosis. There were no significant differences between groups in demographics, operative time, intraoperative crystalloid volume, craniofacial syndromes, or sutures affected. The Study group had higher preoperative Hb (13.9 ± 1.0 vs. 12.6 ± 0.8 g/dL, p < 0.001), lower intraoperative Hb nadir (7.4 ± 1.8 vs. 9.2 ± 1.2 g/dL) lower intraoperative transfusion rate (66.7% vs. 100%, p = 0.008), lower postoperative transfusion rate (0% vs 28.6%, p = 0.03), and exposure to fewer unique units of packed red blood cells (0.7 ± 0.6 vs. 1.5 ± 0.9 units).
    Conclusion: Our protocol resulted in decreased transfusion needs. These results add valuable information to the growing body of work on transfusion reduction in craniosynostosis surgery.
    MeSH term(s) Blood Loss, Surgical/prevention & control ; Blood Transfusion ; Craniosynostoses/surgery ; Erythropoietin ; Humans ; Infant ; Retrospective Studies ; Tranexamic Acid
    Chemical Substances Erythropoietin (11096-26-7) ; Tranexamic Acid (6T84R30KC1)
    Keywords covid19
    Language English
    Publishing date 2020-05-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-020-04654-y
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2036: Show issues Location:
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  5. Article ; Online: Minimizing transfusion in sagittal craniosynostosis surgery: the Children's Hospital of Minnesota Protocol.

    Escher, Paul J / Tu, Albert / Kearney, Susan / Wheelwright, Matthew / Petronio, Joseph / Kebriaei, Meysam / Chinnadurai, Sivakumar / Tibesar, Robert J

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2019  Volume 35, Issue 8, Page(s) 1357–1362

    Abstract: Purpose: To assess the success of a protocol using preoperative erythropoietin (EPO) and iron with perioperative tranexamic acid (TXA) in reducing blood transfusion in sagittal craniosynostosis surgery.: Methods: A retrospective chart review of all ... ...

    Abstract Purpose: To assess the success of a protocol using preoperative erythropoietin (EPO) and iron with perioperative tranexamic acid (TXA) in reducing blood transfusion in sagittal craniosynostosis surgery.
    Methods: A retrospective chart review of all sagittal craniosynostosis patients undergoing open repair at our institution since 2010 was conducted. A novel protocol of preoperative EPO with iron and perioperative TXA, along with a shift away from automatic transfusion, was initiated in 2014. Perioperative hemoglobin levels, length of stay, and transfusion rates were compared between the historical control and the study group receiving the protocol.
    Results: A total of 36 patients met inclusion criteria. Twenty-eight patients were male and 8 were female. Twenty-two patients were in the control group receiving neither TXA nor EPO and automatically received a transfusion, while 14 were in the study group and received the full protocol. There were no significant demographic differences between groups. Within the control group, 100% of patients were transfused compared with 14.3% of the study group (p < 0.0001). The study group also had a shorter postoperative length of stay in the hospital (mean, 3.4 days; range, 3-6) than the control (mean, 4 days; range, 2-5.5, p = 0.038). The study group had a higher preoperative hemoglobin than the control (13.6 vs. 11.8 g/dL, p = 0.0001).
    Conclusion: Our protocol of preoperative EPO and iron with perioperative TXA increased the preoperative hemoglobin and was associated with a low transfusion rate without negatively impacting postoperative course.
    MeSH term(s) Antifibrinolytic Agents/therapeutic use ; Blood Loss, Surgical ; Blood Transfusion ; Child ; Clinical Protocols ; Craniosynostoses/surgery ; Erythropoietin/therapeutic use ; Female ; Hemoglobins/drug effects ; Hospitals, Pediatric ; Humans ; Iron/therapeutic use ; Male ; Minnesota ; Reconstructive Surgical Procedures/adverse effects ; Reconstructive Surgical Procedures/methods ; Retrospective Studies ; Tranexamic Acid/therapeutic use
    Chemical Substances Antifibrinolytic Agents ; EPO protein, human ; Hemoglobins ; Erythropoietin (11096-26-7) ; Tranexamic Acid (6T84R30KC1) ; Iron (E1UOL152H7)
    Language English
    Publishing date 2019-05-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-019-04157-5
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2036: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: A protocol of situation-dependent transfusion, erythropoietin and tranexamic acid reduces transfusion in fronto-orbital advancement for metopic and coronal craniosynostosis

    Escher, Paul J / Tu, Albert D / Kearney, Susan L / Linabery, Amy M / Petronio, Joseph A / Kebriaei, Meysam A / Chinnadurai, Sivakumar / Tibesar, Robert J

    Childs nerv. syst

    Abstract: PURPOSE: Assess the effect of a protocol of preoperative erythropoietin (EPO) and ferrous sulfate in addition to perioperative tranexamic acid (TXA) on blood transfusions in patients with coronal or metopic craniosynostosis undergoing cranial vault ... ...

    Abstract PURPOSE: Assess the effect of a protocol of preoperative erythropoietin (EPO) and ferrous sulfate in addition to perioperative tranexamic acid (TXA) on blood transfusions in patients with coronal or metopic craniosynostosis undergoing cranial vault remodeling (CVR) with fronto-orbital advancement (FOA). METHODS: Retrospective review of all coronal and metopic craniosynostosis patients undergoing CVR and FOA from March 2010 to June 2019 was performed. Before 2014 ("Control group"), all patients received blood transfusion at the start of surgery. In 2014, a protocol of preoperative EPO and ferrous sulfate with perioperative TXA and non-automatic transfusion was instituted ("Study group"). Patient demographics and anthropometrics, perioperative hemoglobin (Hb) levels, and transfusion details were collected and compared. RESULTS: Thirty-six patients met inclusion criteria. Twenty-one patients were in the control group, and 15 in the Study group. Nineteen patients had metopic synostosis, 11 had unicoronal synostosis, and 6 had bicoronal synostosis. There were no significant differences between groups in demographics, operative time, intraoperative crystalloid volume, craniofacial syndromes, or sutures affected. The Study group had higher preoperative Hb (13.9 ± 1.0 vs. 12.6 ± 0.8 g/dL, p < 0.001), lower intraoperative Hb nadir (7.4 ± 1.8 vs. 9.2 ± 1.2 g/dL) lower intraoperative transfusion rate (66.7% vs. 100%, p = 0.008), lower postoperative transfusion rate (0% vs 28.6%, p = 0.03), and exposure to fewer unique units of packed red blood cells (0.7 ± 0.6 vs. 1.5 ± 0.9 units). CONCLUSION: Our protocol resulted in decreased transfusion needs. These results add valuable information to the growing body of work on transfusion reduction in craniosynostosis surgery.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #32388812
    Database COVID19

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  7. Article: Does Timing of Inferior Vena Cava Filter Retrieval Planning Impact Retrieval Rates? A Comparison of Planning Before or After Hospital Discharge.

    Parsons, Benjamin / Polewski, Peter J / Smith, Angela L / Borgert, Andrew J / Azene, Ezana / Ziegelbein, Kurt / Fisher, Mason / Horstman, Andrew / Brozak, Shannon / Escher, Paul J

    WMJ : official publication of the State Medical Society of Wisconsin

    2019  Volume 118, Issue 1, Page(s) 30–34

    Abstract: Introduction: Indwelling inferior vena cava (IVC) filters are associated with complications, and the US Food and Drug Administration recommends their prompt removal when no longer indicated. Therefore, assessing strategies for increasing retrieval rates ...

    Abstract Introduction: Indwelling inferior vena cava (IVC) filters are associated with complications, and the US Food and Drug Administration recommends their prompt removal when no longer indicated. Therefore, assessing strategies for increasing retrieval rates is warranted.
    Objective: To analyze the variability of IVC filter retrieval rates within our institution based on 2 separate, pre-existing processes in which IVC retrieval is planned for before or after hospital discharge.
    Methods: Retrospective chart review was completed for all IVC filters placed in adults between January 2005 and March 2015. Demographics and clinical data related to filter placement and retrieval were abstracted. Patients were classified into 2 groups: patients who had a trauma consultation trauma and nontrauma medical and surgical patients medical. The trauma group patients were subject to a 2-layer tracking process, in which retrieval planning was done before discharge, versus the medical group with a single-layer tracking process and retrieval planning done after discharge.
    Results: Of the 588 filter placements analyzed, 236 were placed in trauma patients and 352 were placed for medical reasons. The retrieval rate of the entire cohort was 45% (262/588), with the rate among trauma patients more than double that of medical patients (155/236, 66% and 107/352, 30%; respectively, P < 0.0001).
    Conclusion: IVC filter retrieval rate was increased when filter removal was included in discharge planning versus postdischarge tracking. A systematic, multidisciplinary strategic approach to IVC filter management has great potential to improve filter utilization, resource allocation, patient safety, and filter retrieval.
    MeSH term(s) Adult ; Aged ; Comorbidity ; Device Removal ; Female ; Humans ; Male ; Middle Aged ; Patient Care Planning ; Patient Discharge ; Retrospective Studies ; Vena Cava Filters/adverse effects
    Language English
    Publishing date 2019-05-13
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 441051-8
    ISSN 1098-1861 ; 0043-6542
    ISSN 1098-1861 ; 0043-6542
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