publication . Article . 2016

Impacto de la hipotermia durante la intervención quirúrgica de craneosinostosis

Víctor Hugo González-Cárdenas; María Victoria Vanegas-Martínez; María Elvira Rojas-Rueda; Claudia Cecilia Burbano-Paredes; Nadya Tatiana Pulido-Barbosa;
Open Access English
  • Published: 01 Jul 2016
  • Publisher: SCARE-Sociedad Colombiana de Anestesiología y Reanimación
  • Country: Colombia
Abstract
Introduction: Hypotherrma is recognized as a risk factor for perioperative complications in paediatric patients. High surgical risk procedures serve as a model of exposure to that risk factor. In particular, surgical correction of craniosynostosis serves as a model for measuring the impact of hypothermia. Objective: To assess hypothermia-related morbidity and mortality in paediatric patients taken to craniosynostosis correction. Methodology: Historical cohort study of patients taken to craniosynostosis correction and exposed to hypothermia. Results: With prior approval of the Ethics Committee of the institution, 54 records were included in the analysis. No statistically significant differences were found between hypothermia and its impact in terms of morbidity and mortality (death, major bleeding, massive haemorrhage massive transfusion, disseminated intravascular coagulation, need for vasopressor support, mechanical ventilation time and length of stay, including admission to the intensive care unit). A clinically significant increase in bleeding (severe and massive) and severe hypothermia was found (28.6% vs. 40% and 14.3% vs. 40%, respectively). Conclusions: No statistical differences were found in terms of morbidity and mortality with severe hypothermia (and moderate/severe hypothermia). Introducción: La hipotermia es un reconocido factor de riesgo de complicaciones peri-operatorias en pacientes pediátricos. Para el estudio de sus impactos, las cirugias de alto riesgo quirúrgico se comportan como un modelo de exposición a dicho factor de riesgo. En este punto, la correcion quirurgica de Craneosinostosis se comporta como un modelo para la medición de los impactos de la hipotermia. Objetivo: Evaluar morbilidad y mortalidad relacionada a hipotermia en pacientes pediátricos llevados a corrección de Craneosinostosis. Metodologia: Estudio de Cohorte Histórico en pacientes pediátricos llevados a corrección de Craneosinostosis expuestos a hipotermia. Resultados: Previa aprobación del Comité de Ética Institucional, incluimos 54 registros en el análisis. No encontramos diferencias estadisticamente significativas entre Hipotermia e Impactos en terminos de morbimortalidad (Mortalidad, Hemorragia Severa, Hemorragia Masiva, Trasfusión Masiva, Coagulación Intravascular Diseminada, Necesidad de Soporte Vasopresor y Tiempos de Ventilacion Mecanica, y Hospitalización, incluso en Cuidado Intensivo). Hallamos un aumento clinicamente significativo en la hemorragia (severa y masiva) e Hipotermia Severa, (28.6% Vs. 40% y 14.3% Vs. 40%, respectivamente). Conclusiones: La hipotermia severa (y moderada a severa) no demostro en nuestros pacientes diferencias estadisticas para morbilidad y mortalidad.
Subjects
free text keywords: Hypothermia, Mortality, Morbidity, Craniosynostoses, Blood transfusion, Hipotermia, Mortalidad, Morbilidad, Craneosinostosis, Transfusión sanguínea, Anesthesiology and Pain Medicine, Critical Care and Intensive Care Medicine, Surgery, medicine.medical_specialty, medicine, Massive haemorrhage, Anesthesia, Risk factor, Perioperative, Hypothermia, medicine.symptom, business.industry, business, Craniosynostosis, medicine.disease, Intensive care unit, law.invention, law, Disseminated intravascular coagulation, Mechanical ventilation, medicine.medical_treatment
30 references, page 1 of 2

1. Guyton AC, Hall JE. Tratado de Fisiología Médica. In: Guyton AC, editor. Regulación de la temperatura corporal y fiebre. 12th ed. Barcelona, Espan˜ a: Elsevier Saunders; 2011. p. 867 [chapter 73].

2. Young C, Sladen R. Complications in anesthesia. In: Atlee JL, editor. Hypothermia. 2th ed. Philadelphia, PA: Elsevier Saunders; 2007. p. 419-22 [chapter 100].

3. Sullivan KJ. Complications in anesthesia. In: Atlee JL, editor. Hypothermia in pediatric patients. 2th ed. Elsevier Saunders; 2007. p. 663-6 [chapter 165].

4. González VH, Vanegas MV, Rojas ME, Guevara NS, Prada JR, Baquero P. Anestesia para craneosinostosis. Rev Colomb Anestesiol. 2014;42:199-204. [OpenAIRE]

5. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anaesthesiology. 2008;109:318-38.

6. Luginbuehl I, Bissonnettee B. Practice of anesthesia in infants and children. In: Coté, editor. Thermal regulation. 4th ed. Philadelphia, PA: Saunders Elsevier; 2009. p. 553-67 [chapter 25].

7. Bailey J, Rose P. Temperature measurement in the preterm infant: a literature review. J Neonatal Nurs. 2000;6:28-32.

8. Castillo CG, Candia CA, Marroquín HA, Aguilar F, Benavides JJ, Alvarez JA. Manejo de la temperatura en el perioperatorio y frecuencia de hipotermia inadvertida en un hospital general. Rev Colomb Anestesiol. 2013;41:97-103.

9. Lee HQ, Hutson JM, Wray AC, Lo PA, Chong DK, Holmes AD, et al. Analysis of morbidity and mortality in surgical management of craniosynostosis. J Craniofac Surg. 2012;23:1256-61.

10. Choi AY, Ahmad NS, de Beer DA. Metabolic changes during major craniofacial surgery. Paediatr Anesth. 2010;20:851-5.

11. Goyal K, Chaturvedi A, Prabhakar H. Factors affecting the outcome of patients undergoing corrective surgery for craniosynostosis: a retrospective analysis of 95 cases. Neurol India. 2011;59:823-8.

12. Lavoie J. Blood transfusion risks and alternative strategies in pediatric patients. Pediatr Anesth. 2011;21:14-24.

13. Verma S, Eisses M, Richards M. Blood conservation strategies in pediatric anesthesia. Anesthesiol Clin. 2009;27: 337-51.

14. Crisostomo MM, Hernandez AL, Ordo n˜ez G, Riera C. La hipotermia y sus efectos durante la anestesia en nin˜ os. Rev Mex Pediatr. 2011;78:131-8.

15. Quiroga A, Chattas G, Gil A, Ramirez M, Montes MT, Iglesias A, et al. Guía de practica clínica de termorregulación en el recién nacido. Sociedad Iberoamericana de Neonatología. 2010:1-25 [Cited 10 May 2016]. Disponible en: http://www.sld.cu/ galerias/pdf/sitios/williamsoler/consenso termoreg.pdf

30 references, page 1 of 2
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