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

  • Paul J. Escher
  • Albert Tu
  • Robert J. TibesarEmail author
Letter to the Editor’s Reply

Dear Editor:

We wish to thank Dr. Steinbok for his thoughtful commentary and wholeheartedly agree that a contributor to the reduction in transfusion rate was a change in protocol from prophylactic transfusion of all patients to transfusion only when certain thresholds had been met. We agree completely that a key component to reducing the transfusion rate is making transfusion reduction a clearly communicated goal to all members of the surgery team. In this paper, we attempt to describe our experience with the entire Children’s Minnesota protocol for transfusion reduction, which include EPO, TXA, and establishing a clear threshold for transfusion. We would support other centres sharing their experiences with craniosynostosis surgery and the protocols they have established to reduce transfusion and improve outcomes. For future study, we do think it to be important to determine the utility of individual components of each protocol and we do look forward to sharing our results again in the future.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of Minnesota Medical SchoolMinneapolisUSA
  2. 2.Children’s Hospital of Eastern OntarioOttawaCanada
  3. 3.Children’s Minnesota ENT and Craniofacial SurgeryMinneapolisUSA

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