Discussion
blood loss
BLOOD LOSS, EXSANGUINATION, INTRAOPERATIVE BLOOD LOSS
This randomized trial evaluated the efficacy of SET in reducing perioperative blood loss and transfusion in pediatric femoral surgeries in which the standard pneumatic tourniquet cannot be used. An unplanned interim analysis revealed that SET significantly reduces the body weight-adjusted transfusion volume and estimated intraoperative blood loss without increasing the postoperative total drained volume. In addition, patients who underwent SET application during operation experienced less operative time with borderline statistical significance.Several studies reported that SET was superior in exsanguination and could provide a bloodless surgical field more effective than the pneumatic tourniquet [This study found that SET significantly reduced the body weight-adjusted transfusion volume estimated intraoperative blood loss for femoral-related orthopedic surgeries, similar to the previous study [There were some limitations in this study. First, surgeon blinding was impossible, resulting in a potential for biases during the operation. Second, the interim analysis in this study was not prespecified. However, this interim analysis was recommended by an independent DSMB for patients’ safety. Nevertheless, the level of significance in this study has been adjusted for interim analysis.