STOMATOLOGY EDU JOURNAL 2017, Volume 4, Issue 3 SEJ_3-2017_Online - Page 43

Table 10. Transfusion need for bimaxillary orthognathic surgery without additional or complex procedures (percentage). Bimaxillary surgery without additional or complex procedures n° patients Autologous (%) Homologous (%) Predonation policy 969 324 18 342* No predonation policy 1264 0 187 187 2233 324 205 529 Total (%) Table 11. Transfusion rates for bimaxillary surgery over the years in centers without predonation policy. Bimaxillary surgery without additional or complex procedures n° patients Homologous transfusion (n) 1985–1995 132 54 41% 1996–2005 598 128 21% ≥2006 534 5 1% 1985–2012 1331 187 15% Interval (year) Homologous transfusion (%) Table 12. Transfusion rates for bimaxillary surgery over the years in centers with a predonation policy, expressed in numbers of patients transfused. Bimaxillary surgery without additional or complex procedures n° patients Homologous transfusion Autologous transfusion 1985–1995 129 8 34 42 1996–2005 430 2 161 161 ≥2006 410 8 129 136 969 18 324 342* Interval (year) Total TRANSFUSION NEED IN ORTHOGNATHIC surgery - A REVIEW *some patients received both autologous and homologous transfusion and are counted as 1 patient in the sum. Table 13. Transfusion rates for bimaxillary surgery over the years in centers with a predonation policy, expressed in % of patients transfused. Bimaxillary surgery without additional or complex procedures n° patients Homologous transfusion Autologous transfusion Total 1985–1995 129 6% 26% 33% 1996–2005 430 0,5% 37% 37% ≥2006 410 2% 31% 33% 969 2% 33% 35% Interval (year) hypotension deep and omitting the papers without any indication of blood pressure control, we find a group of 2123 procedures (Table 15, Table 16). The groups of normotension are small groups, but both are prospective, well-controlled studies with radial artery catheter measurements of mean arterial pressure. The least that can be said from these figures is that controlled deep hypotension (MAP between 50–65 mm Hg) seems not to influence the transfusion need more than controlled mild hypotension. It seems difficult to compare the mean blood loss in this series, but the spread in reported mean blood losses varies from 256.7 mL (Ueki et al., 2005) 21 to 1300 mL (Böttger, 2007). 4 Stomatology Edu Journal The statistical methods used in Table 15 and Table 16 calculated 95% exact confidence intervals (CI) for the individual studies. The overall transfusion rates and corresponding 95% confidence intervals are estimated using a probit-normal model. No significant interaction between predonation and hypotension could be shown (p=0.8072). After correction for predonation, no significant effect of hypotension could be shown (p=0.9616). 3.1.5. Bimaxillary surgery with additional complex procedures Because Flood et al. (1990) 11 seems to be an outlier concerning their transfusion policy, these data were not retained. The papers by Kasahara et al. 193