Impact of hypothermia during craniosynostosis repair surgery

• Published in: Colombian journal of anesthesiology (Inglâes) 2016-07, Vol.44 (3), p.235-241
• Main Authors: González-Cárdenas, Víctor Hugo, Vanegas-Martínez, María Victoria, Rojas-Rueda, María Elvira, Burbano-Paredes, Claudia Cecilia, Pulido-Barbosa, Nadya Tatiana
• Format: Article
• Language: English
• Subjects: Blood transfusion; Craneosinostosis; Craniosynostoses; Hipotermia; Hypothermia; Morbidity; Morbilidad; Mortalidad; Mortality; Transfusión sanguínea
• ISSN: 2256-2087
• DOI: 10.1016/j.rcae.2016.04.007

Hypothermia 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. To assess hypothermia-related morbidity and mortality in paediatric patients taken to craniosynostosis correction. Historical cohort study of patients taken to craniosynostosis correction and exposed to hypothermia. 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). No statistical differences were found in terms of morbidity and mortality with severe hypothermia (and moderate/severe hypothermia). 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 quirurgico 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. Evaluar morbilidad y mortalidad relacionada a hipotermia en pacientes pediátricos llevados a corrección de Craneosinostosis. Estudio de Cohorte Histórico en pacientes pediátricos llevados a corrección de Craneosinostosis expuestos a hipotermia. 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). La hipotermia severa (y moder