A 16-year-old, transfusion-naive female was operated on for spinal fusion with instrumentation, bone graft, and spinal monitoring extending from T3 through L3. The patient's weight was 87.3 kg, and her BMI was 34.19 kg/m 2 . Medical history Thoracolumbar kyphosis Chronic back pain Migraine headaches Asthma Menorrhagia A preoperative sleep study was carried out for daytime somnolence that did not demonstrate sleep-disordered breathing, alveolar hypoventilation, or periodic limb movements. She had undergone a tonsillectomy and adenoidectomy a few years ago. She reported post-operative bleeding on day five after the surgery.
No underlying bleeding disorder was found in the preoperative hematology consultation and evaluation. The case proceeded uneventfully, and the RBCs were transfused. Cell saver blood (400 ml) had already been given to the patient earlier in the case. The estimated blood…
