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Rivista di Pediatria, Neonatologia, Medicina dell’Adolescenza
e Neuropsichiatria Infantile
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Pediatrica 2015 Sep 01
Early postoperative complications of intracranial tumors in children
Mastro-Martínez I. 1, Iglesias-Bouzas M. I. 1, Cabeza-Martin B. 1, Oñoro-Otero G. 1, Pérez-Díaz C. 2, Serrano-González A. 1, Casado-Flores J. 1 ✉
1 Pediatric Intensive Care Unit, HUI Niño Jesús, Madrid, Spain;
2 Department of Neurosurgery, HUI Niño Jesús, Madrid, Spain
BACKGROUND: To describe the complications experienced by patients after central nervous system tumor resection during PICU admission. To assess the association between epidemiological, clinical data and tumor characteristics prior to surgery and presence of postoperative complications.
METHODS: We design an observational, descriptive and retrospective study by review of medical records. Patients aged 0-18 years, admitted to the PICU of our hospital, after surgery for tumor resection in the central nervous system.
RESULTS: We collected a total of 145 postoperative. At PICU, 48.3% of the patients (70/145) had some type of postoperative complication. It they were, in order of frequency: a new neurological deficit at discharge (29%, 42/145), pneumocephalus (21%, 30/145), electrolyte disturbances (17.9%, 26), infection (16.6%, 24), anemia (8.3%, 12), seizures (7.6%, 11), endocrine disorders (7.6%, 11), intracranial hypertension (5.5%, 8) and stroke (7, 4.8%). One patient died. There was no difference in overall complication and the tumor site. However, supratentorial tumors had less need for MV (73% vs. 92%, p = 0.002, OR 2.7 [1.2-6.1]), shorter duration for MV (11 hours vs 48 hours, p = 0.02), lower frequency of neurological deficit (22% vs. 37%, p = 0.004, OR 1.4 [1-2.1]) and cerebrospinal fluid fistula (1% vs. 13%, p = 0.004, OR 2.1 [1.6- 2.8]). They were more frequent seizures (13% vs. 2%, p = 0.024, OR 1.8 [1.4-2.3]), central diabetes insipidus (17% vs. 0%, p <0.001, OR 4.3 [1.6-11.7]) and endocrine disruption (14% vs. 0%, p = 0.001, OR 2 [1.7-2.4]).
CONCLUSION: The intracranial tumors surgery requires monitoring in intensive care because the risk of postoperative complications is high. The tumor location is related to the occurrence of some of these complications.