Abstract: Objective To explore the effects of intraoperative massive transfusion on laboratory indexes and clinical outcomes for children with the intracranial space-occupying lesion (SOL). Methods A total of 56 children with intracranial SOL were enrollled from January 2021 to December 2021 in the Beijing Children's Hospital. All of them underwent craniotomy for removal of intracranial occupancy. The children were divided into massive transfusion (MT) group (n=27) and non-massive transfusion (NMT) group (n=29) according to intraoperative blood transfusion. The indexes (blood routine, coagulation function, some biochemical indicators) and clinical outcomes were analyzed. Results After transfusion, children in NMT group had prolonged PT, decreased K⁺ and Ca²⁺ concentration, increased Cl^- and Na⁺ concentration, and blood glucose after transfusion (P<0.05), while children in MT group had reduced PLT, prolonged PT, decreased FIB, K⁺, and Ca²⁺ concentration, and increased Cl^-, Na⁺ concentration, and blood glucose (P<0.05). The changes in laboratory indexes before and after transfusion showed that ΔPLT, ΔK⁺, ΔNa⁺, ΔGLU, and ΔFIB were more significant in MT group compared with NMT group (P<0.05). Meanwhile, compared to NMT group, intensive care unit (ICU) length of stay and total length of stay were significantly longer in MT group. The incidence of postoperative hypokalemia [74.1% (20/27) vs. 27.6% (8/29)], hypernatremia [22.2% (6/27) vs. 3.4% (1/29)], and infection [48.1% (13/27) vs. 13.8% (4/29)] in MT group was significantly higher than that of NMT group (P<0.05). Conclusion Intraoperative massive transfusion in SOL children may affect the coagulation function, biochemical parameters, and immune function.

Key words: Children, Space occupying lesion, Massive transfusion, Laboratory indexes, Clinical outcome