Impact of hypothermia during craniosynostosis repair surgery
Keywords:
Hypothermia, Mortality, Morbidity, Craniosynostoses, Blood transfusion
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).
References
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27. Soriano SG, Eldredge EA, Rockoff MA. Pedriatic neuroanesthesia. Neuroimag Clin N Am. 2007;17:259-67.
28. de Beer D, Bingham R. The child with facial abnormalities. Curr Opin Anesthesiol. 2011;24:282-8.
29. Seruya M, Oh AK, Rogers GF, Boyajian MJ, Myseros JS, Yaun AL, et al. Factors related to blood loss during fronto-orbital advancement. J Craniofac Surg. 2012;23:358-62.
30. Alvarado J, Arroyave H, Casas F. Hipotermia terapêutica post-reanimación cardiopulmonar prolongada en paro cardiaco debido a tromboembolismo pulmonar. Reporte de Caso. Rev Colomb Anestesiol. 2014;42:317-20.
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.
5. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 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 o morbidity and mortality in surgical managemen 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, Ordonez G, Riera C. La hipotermia y sus efectos durante la anestesia en niños. 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.
16. Witt L, Dennhardt N, Eich C, Mader T, Fischer T, Fischer T, et al. Prevention of intraoperative hypothermia in neonates and infants: results of a prospective multicenter observational study with a new forced-air warming system with increased warm air flow. Pediatr Anaesth. 2013;23:469-74.
17. Vega RA, Lyon C, Kierce JF, Tye GW, Ritter AM, Rhodes JL. Minimizing transfusion requirements for children undergoing craniosynostosis repair: the CHoR protocol. J Neurosurg Pediatr. 2014;14:190-5.
18. Barnett S, Moloney C, Bingham R. Perioperative complications in children with Apert syndrome: a review of 509 anesthetics. Pediatr Anesth. 2011:72-7.
19. Goobie S, Meier P Pereira L, McGowan F Prescilia R, Scharp L, et al. Efficacy of tranexamic acid in pediatric craniosynostosis surgery. Anesthesiology. 2011;14:862-71.
20. Guzzetta NA, Miller BE. Principles of hemostasis in children: models and maturation. Paediatr Anesth. 2011;21:3-9.
21. Stricker PA, Shaw TL, Desouza DG, Hernandez SV, Bartlett SP, Friedman DF, et al. Blood loss, replacement, and associated morbidity in infants and children undergoing craniofacial surgery. Paediatr Anesth. 2010;20:150-9.
22. Kho JL, Gries H. Perioperative management of pediatric patients with craneosynostosis. Anesthesiol Clin. 2007;25:465-81.
23. Pietrini D. Intraoperative management of blood loss during craniosynostosis surgery. Paediatr Anesth. 2013;23:278-80.
24. Fearon JA, Cook TK. Effects of hypotensive anesthesia on blood transfusion rates in craniosynostosis corrections. Plast Reconstr Surg. 2014;133:1133-6.
25. Meyer P, Renier D, Arnaud E, Jarreau MM, Charron B, Buy E, et al. Blood loss during repair of craniosynostosis. Br J Anaesth. 1993;71:854-7.
26. Allareddy V. Prevalence and impact of complications on hospitalization outcomes following surgical repair for craniosynostosis. J Oral Maxillofac Surg. 2014;72:2522-30.
27. Soriano SG, Eldredge EA, Rockoff MA. Pedriatic neuroanesthesia. Neuroimag Clin N Am. 2007;17:259-67.
28. de Beer D, Bingham R. The child with facial abnormalities. Curr Opin Anesthesiol. 2011;24:282-8.
29. Seruya M, Oh AK, Rogers GF, Boyajian MJ, Myseros JS, Yaun AL, et al. Factors related to blood loss during fronto-orbital advancement. J Craniofac Surg. 2012;23:358-62.
30. Alvarado J, Arroyave H, Casas F. Hipotermia terapêutica post-reanimación cardiopulmonar prolongada en paro cardiaco debido a tromboembolismo pulmonar. Reporte de Caso. Rev Colomb Anestesiol. 2014;42:317-20.
How to Cite
1.
González-Cárdenas VH, Vanegas-Martínez MV, Rojas-Rueda ME, Burbano-Paredes CC, Pulido-Barbosa NT. Impact of hypothermia during craniosynostosis repair surgery. Colomb. J. Anesthesiol. [Internet]. 2016 Jul. 1 [cited 2024 Apr. 26];44(3):235-41. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/376
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2016-07-01
How to Cite
1.
González-Cárdenas VH, Vanegas-Martínez MV, Rojas-Rueda ME, Burbano-Paredes CC, Pulido-Barbosa NT. Impact of hypothermia during craniosynostosis repair surgery. Colomb. J. Anesthesiol. [Internet]. 2016 Jul. 1 [cited 2024 Apr. 26];44(3):235-41. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/376
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