Metabolic changes and factors influencing base deficit in infants undergoing craniosynostosis surgery: a retrospective study

Abstract

Almost all patients developed intraoperative negative BD, which was prolonged in the postoperative period. The most important risk factors for developing negative BD are the amount of blood loss and duration of hypotension.

Early postoperative follow-up after craniosynostosis surgery

“…Length of PICU stay was 2.63 ± 0.88 days (median: 2 days, 2-6 days) in the present study. Despite the high incidence of events (regardless of major or minor), the length of stay was concordant with other reports by Ali et al with 1.9 ± 0.5 days, and by Goobie et al with a median of 1 day, ranging from 1 to 6 days (19,2). Looking at the significantly high rates of incidents, the first 24 h after surgery seem to require delicate care of the patients operated on with open surgical techniques, and they should be admitted to the PICU for close monitoring.…”

“…Prolonged surgery is another factor for hypotension and metabolic acidosis (11,21). BE values in the present study were -8.9 ± -2.0 mmol/L, similar to the BE values of 7.74 mmol/L reported by Ali et al (19), and were directly related to hypotension and length of surgery, regardless of age or procedure type.…”

“…Rates of minor events were 82.9% for hypothermia, 24.4% for FUO, 9.8% for infections, 14.6% for hyperglycemia, and 9.8% for seizures. Maintaining normothermia and normoglycemia is equally important in metabolic monitoring (14,19). Hypothermia is a known factor of coagulopathy and metabolic acidosis due to blood loss at surgery, refrigerated blood transfusions, room temperature changes, inadequate end organ perfusion, or heat loss from infants' relatively large head/body surface area (11,14).…”

“…BE reaches its lowest values at the end of surgery and normalizes between 9.5 and 12 h in the postoperative stage (19,20). Lower base deficits and higher lactate levels can be expected due to infants' relatively large head/body surface area, which contributes to additional fluid and blood loss and results in hypothermia, hypotension, and inadequate tissue perfusion (19). Prolonged surgery is another factor for hypotension and metabolic acidosis (11,21).…”

“…In most patients, metabolic acidosis develops intraoperatively and extends to the postoperative period (14). BE reaches its lowest values at the end of surgery and normalizes between 9.5 and 12 h in the postoperative stage (19,20). Lower base deficits and higher lactate levels can be expected due to infants' relatively large head/body surface area, which contributes to additional fluid and blood loss and results in hypothermia, hypotension, and inadequate tissue perfusion (19).…”