Background: Resective epilepsy surgery is an established and effective method to reduce seizure burden in\ndrug-resistant epilepsy. It was the objective of this study to assess intraoperative blood loss, transfusion\nrequirements and the degree of hypothermia of pediatric epilepsy surgery in our center.\nMethods: Patients were identified by our epilepsy surgery database, and data were collected via retrospective chart\nreview over the past 25 years. Patients up to the age of 6 years were included, and patients with insufficient data\nwere excluded.\nResults: Forty-five patients with an age of 3.2 �± 1.6 (mean �± SD) years and a body weight of 17 [14; 21.5] kg (median\n[25%, 75% percentile]) were analysed. Duration of surgery was 3 h 49 min �± 53 min, which was accompanied by an\nintraoperative blood loss of 150 [90; 300] ml. This corresponded to 11.7 [5.2; 21.4] % of estimated total blood volume,\nranging from 0 to 75%. A minimal haemoglobin count of 8.8 �± 1.4 g/dl was measured, which was substituted with\nerythrocyte concentrate (100 [0; 250] ml) in 23 patients. Body core temperature dropped from 36.0 �± 0.7�°C at baseline\nto a minimum of 35.7 �± 0.7�°C, and increased significantly (p < 0.001) thereafter to 37.1 �± 0.7�°C until the end of surgery.\nA significant (p = 0.0003) correlation between duration of surgery and blood loss (Pearson r = 0.52) was observed.\nHowever, age, minimal body temperature or number of antiepileptic drugs seemed to have no impact on blood loss.\nConclusion: Resective epilepsy surgery is a safe procedure even in the pediatric population, however it is associated\nwith significant blood loss especially during long surgical procedures.
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