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Early postoperative complications of intracranial tumors in children
Ignacio Mastro-Martínez1, Maria I Iglesias-Bouzas2, Beatriz Cabeza Martin2
1Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain - Ignacio.mastro@salud.madrid.org.
Insights
Pediatric central nervous system tumor resection has a high risk of postoperative complications in the pediatric intensive care unit (PICU). Tumor location influences specific complication types, highlighting the need for intensive monitoring.
Area of Science:
- Pediatric Neurosurgery
- Intensive Care Medicine
- Oncology
Background:
- Central nervous system (CNS) tumors are a significant concern in pediatric oncology.
- Postoperative complications following CNS tumor resection require specialized care in pediatric intensive care units (PICUs).
Purpose of the Study:
- To describe complications in pediatric patients after CNS tumor resection during PICU admission.
- To assess the association between patient/tumor characteristics and postoperative complications.
Main Methods:
- Retrospective observational study analyzing medical records of patients aged 0-18 years.
- Inclusion criteria: PICU admission post-CNS tumor resection.
Main Results:
- 48.3% of patients experienced postoperative complications, including new neurological deficits, pneumocephalus, and infections.
- Supratentorial tumors were associated with less need for mechanical ventilation and fewer neurological deficits.
- Seizures and endocrine disruptions were more frequent with supratentorial tumors.
Conclusions:
- Intracranial tumor surgery necessitates intensive care monitoring due to high complication rates.
- Tumor location is a significant factor in the occurrence of specific postoperative complications.
Background:
The aim of this study was to describe the complications experienced by patients after central nervous system tumor resection during pediatric intensive care Unit (PICU) admission. Our attempt was to assess the association between epidemiological, clinical data and tumor characteristics prior to surgery and presence of postoperative complications.
Methods:
We design an observational, descriptive and retrospective study by review of medical records. Patients aged 0-18 years, admitted to the PICU of our hospital, after surgery for tumor resection in the central nervous system.
Results:
We collected a total of 145 postoperative. At PICU, 48.3% of the patients (70/145) had some type of postoperative complication. It they were, in order of frequency: a new neurological deficit at discharge (29%, 42/145), pneumocephalus (21%, 30/145), electrolyte disturbances (17.9%, 26), infection (16.6%, 24), anemia (8.3%, 12), seizures (7.6%, 11), endocrine disorders (7.6%, 11), intracranial hypertension (5.5%, 8) and stroke (7, 4.8%). One patient died. There was no difference in overall complication and the tumor site. However, supratentorial tumors had less need for MV (73% vs. 92%, P=0.002, OR 2.7 [1.2-6.1]), shorter duration for MV (11 hours vs. 48 hours, P=0.02), lower frequency of neurological deficit (22% vs. 37%, P=0.004, OR 1.4 [1-2.1]) and cerebrospinal fluid fistula (1% vs. 13%, P=0.004, OR 2.1 [1.6- 2.8]). They were more frequent seizures (13% vs. 2%, P=0.024, OR 1.8 [1.4-2.3]), central diabetes insipidus (17% vs. 0%, P<0.001, OR 4.3 [1.6-11.7]) and endocrine disruption (14% vs. 0%, P=0.001, OR 2 [1.7-2.4]).
Conclusions:
The intracranial tumors surgery requires monitoring in intensive care because the risk of postoperative complications is high. The tumor location is related to the occurrence of some of these complications.
