Blood pressure rose to 125/80 mm Hg and 115 bpm on induction. Anesthesia wa maintained with air, 40% oxygen, and 0.75-1.5% isoflurane. Adequate abdominal muscle relaxation was achieved with vecuronium. Additional fentanyl titrated to 6 micrograms/kg was given. A triple lumen catheter was placed in the left subclavian vein for post-operative TPM. A blood specimen was collected with a hematocrit of 24%.

• The abdomen was explored. Approximately, 500 cc's of clotted blood was found; however, no obvious source of bleeding was identified.
• An additional 200 cc's of packed RBC's were transfused over the next hour.
• Heart rate and blood pressure remained stable at 80-100 bpm and 110-125/70-80 through the procedure.
• Patient's temperature continued to climb with maximum temperature of 102F.
• The abdomen was closed and the patient was transferredto the pediatric intensive care unit in stable condition.
• Urine output was 2cc/kg for the sixty minute procedure.