Évaluation des pertes sanguines peropératoires au cours de l'exérèse de tumeurs intracrâniennes par craniotomie chez l'enfant

The objective of this study was to compare the CBL (calculated blood loss) and the MBL (measured blood loss) for the assessment of the intraoperative surgical bleeding during craniotomy for brain tumor removal in children. Monocentric retrospective study over a 2-year period including craniotomies for brain tumor removal in children. The intraoperative blood loss was measured, and calculated according to a previously described formula. A Spearman's correlation analysis between CBL and MBL was performed, as a concordance analysis using the method of Bland and Altman. Eighty children aged 8 ± 5 years were included. The MBL were significantly lower than the CBL (4.04 [1.96-7.23] vs 11.34 [7.21-17.45] mL/kg, P < 0.0001). There was a moderate correlation between MBL and CBL (rho = 0.52, [95% confidence interval 0.34-0.66], P < 0.0001). The MBL underestimated the intraoperative blood loss (mean bias of −8.0 mL/kg) and its accuracy was poor (limits of agreement between −24.2 mL/kg and 8.3 mL/kg). Our results suggest that the MBL should not be used in clinical practice to evaluate the intraoperative blood loss during paediatric craniotomy for brain tumor removal, exposing to the risks of underestimation of intraoperative bleeding and delay in transfusion.