Postoperative Outcome in Non-Preterm Infants Under One Year Old in Non-Cardiac Surgery
Department of Pediatric and Obstetric Anesthesia and Critical Care, Hôpital Universitaire Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, Paris, France
*Corresponding Author: Claudine Kumba, Department of Pediatric and Obstetric Anesthesia and Critical Care, Hôpital Universitaire Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, Paris, France.
May 10, 2021; Published: July 05, 2021
Background: An observational study conducted earlier to determine predictors of postoperative outcome in non-cardiac surgical pediatric patients showed that factors which influenced postoperative evolution were multiple. These included American Society of Anesthesiologists (ASA) score, transfusion, age, emergency surgery, and surgery.
Objectives: To describe in details outcomes in non-preterm children under one year old included in the initial study.
Methods: Secondary analysis of the initial retrospective observational study in 594 patients with a mean age of 90.86 ± 71.80 months.
The Ethics Committee approved the study under the registration number 2017-CK-5-R1.
Results: There were 97 non-preterm children included with a mean age of 4.44 ± 3.49 months.
Mean weight was 5.13 ± 2.74 kilograms. There were 48 abdominal surgical patients (49.49%), 48 neurosurgical patients (49.49%) and 1 orthopedic surgery patient (1.03%). 30 patients had intra-operative and or postoperative complications (organ failure or sepsis) (30.93%). The most common intra-operative complication was hemorrhagic shock (5.16%); the most affected system in the postoperative period was the respiratory system in terms of organ failure and pulmonary sepsis with an overall rate of 12.38%; the most common postoperative infection was septicemia (7.22%). The rate of postoperative renal failure was 1.03%. There were 5 in-hospital deaths (5.16%) and all were ASA III, IV and V patients managed on an emergency basis.
Conclusion: In this cohort of 97 non-preterm infants under one year old, the rate of patients with intra-operative and or postoperative complications was 30.93%. Patients with fatal outcome had an ASA score III or more and were managed on an emergency basis.
It is time to reconsider integrating goal directed therapies in intra-operative patient management to improve postoperative outcome.
Keywords: Children Under One Year Old; Outcome; Non-Cardiac Surgery
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