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[Limited value of routine preoperative laboratory studies in children]
T W de Vries1, J S Harbers, H S Heymans
1Academisch Ziekenhuis, Afd, Kindergeneeskunde, Groningen.
Insights
Routine preoperative lab tests in low-risk children rarely yield abnormal results impacting surgery. Hemoglobin measurement may suffice, particularly for non-white pediatric patients undergoing anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Clinical Pathology
Context:
- Routine preoperative laboratory testing is standard for pediatric surgical patients.
- The necessity and impact of these tests on perioperative outcomes are debated.
Purpose:
- To evaluate if routine preoperative laboratory tests in low-risk children reveal abnormalities that influence anesthesia or surgical procedures.
- To identify potential reductions in routine testing for pediatric surgical patients.
Summary:
- A retrospective chart review of 143 low-risk children undergoing ENT surgery was conducted.
- Only 1.4% of patients had abnormal lab results, with no correlation to perioperative complications.
- Specific abnormalities included low hemoglobin, calcium, and albumin levels.
Impact:
- Findings suggest routine preoperative laboratory testing in pediatric surgical patients may be excessive.
- Recommendations include potentially limiting tests to hemoglobin measurement, especially for non-white children.
- This could streamline preoperative protocols and reduce healthcare costs without compromising patient safety.
Abstract:
In order to determine whether in routine preoperative laboratory testing of children abnormal results were reported which influenced the course of the anesthesia or of the operation, a retrospective survey of charts was carried out at the University Children's Hospital, Groningen. The patients involved were 143 low risk children, admitted for ENT surgery. The main outcome measures were abnormalities and perioperative complications. There were 1.4% laboratory abnormalities (including five children with a haemoglobin concentration less than 7.1 mmol/l, one with a calcium concentration less than 2.2 mmol/l, one with an albumin concentration less than 30 g/l), and seven complications (bradycardia during intubation, bronchial obstruction, bleeding, excessive vomiting (three times), and leakage of perilymphatic fluid). There were no correlations between the abnormal test results and the complications. Routine laboratory testing in children scheduled for surgery might be reduced to measurement of haemoglobin, especially in non-white children.