ORIGINAL ARTICLE   

Minerva Pediatrica 2017 October;69(5):381-90

DOI: 10.23736/S0026-4946.16.04277-8

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Early postoperative complications of intracranial tumors in children

Ignacio MASTRO-MARTÍNEZ ✉, Maria I. IGLESIAS-BOUZAS, Beatriz CABEZA MARTIN, Gonzalo OÑORO-OTERO, Carlos PEREZ-DIAZ, Ana SERRANO-GONZALEZ, Juan CASADO-FLORES

Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain

BACKGROUND: The aim of this study was to describe the complications experienced by patients after central nervous system tumor resection during pediatric intensive care Unit (PICU) admission. Our attempt was 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]).
CONCLUSIONS: 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.

KEY WORDS: Central nervous system neoplasms - Postoperative care - Postoperative complications - Intensive care units - Pediatrics