Development of Consensus Based Best Practice Guidelines for Perioperative Management of Blood Loss in Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Delphi process with multiple iterative rounds using a nominal group technique. The aim of this study was to use expert opinion to achieve consensus on various methods for minimizing blood loss in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Perioperative blood loss management represents a critical component of safely performing PSF in children with AIS. Little consensus exists on ways to mitigate excessive blood loss after PSF. An expert panel composed of 21 pediatric spine surgeons was selected. Using the Delphi process and iterative rounds using a nominal group technique, participants in this panel were presented with a detailed literature review and asked to voice opinion collectively during three rounds of voting. Agreement >80% was considered consensus. Interventions without consensus were discussed and revised, if feasible. Consensus was reached to support 21 best practice guideline measures for perioperative management of blood loss in patients undergoing PSF for AIS. Areas included preoperative assessment and preparation, intraoperative strategies to decrease blood loss, and postoperative transfusion indications. We present a consensus-based best practice guideline consisting of 21 recommendations for strategies to minimize and manage blood loss during PSF. This can serve to reduce variability in practice in this area, help develop hospital specific protocols, and guide future research.

Fletcher ND ，Marks MC ，Asghar JK ，Hwang SW ，Sponseller PD ，Harms Study Group ，Newton PO ... -  《-》

Development of Consensus-Based Best Practice Guidelines for Postoperative Care Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Fletcher ND ，Glotzbecker MP ，Marks M ，Newton PO ，Harms Study Group ... -  《-》

Building consensus: development of a Best Practice Guideline (BPG) for surgical site infection (SSI) prevention in high-risk pediatric spine surgery.

Vitale MG ，Riedel MD ，Glotzbecker MP ，Matsumoto H ，Roye DP ，Akbarnia BA ，Anderson RC ，Brockmeyer DL ，Emans JB ，Erickson M ，Flynn JM ，Lenke LG ，Lewis SJ ，Luhmann SJ ，McLeod LM ，Newton PO ，Nyquist AC ，Richards BS 3rd ，Shah SA ，Skaggs DL ，Smith JT ，Sponseller PD ，Sucato DJ ，Zeller RD ，Saiman L ... -  《-》

The role of Amicar in same-day anterior and posterior spinal fusion for idiopathic scoliosis.

Thompson GH ，Florentino-Pineda I ，Poe-Kochert C ，Armstrong DG ，Son-Hing JP ... -  《-》

The effect of amicar on perioperative blood loss in idiopathic scoliosis: the results of a prospective, randomized double-blind study.

Florentino-Pineda I ，Thompson GH ，Poe-Kochert C ，Huang RP ，Haber LL ，Blakemore LC ... -  《-》