Post-operative intravenous fluid administration for infant cleft surgery: An observational study

Area of Science:

• Pediatric Surgery
• Craniofacial Surgery
• Anesthesiology

Background:

• Post-operative intravenous fluid administration is a common practice following cleft surgery.
• Previous studies suggest a link between intravenous fluids and increased length of hospital stay after primary cleft repair.

Purpose of the Study:

• To investigate the relationship between post-operative intravenous fluid administration and length of stay in infants undergoing primary cleft repair.
• To compare fluid administration, oral feeding tolerance, and length of stay based on cleft type and surgical procedure.

Main Methods:

• Observational study of 110 non-syndromic infants undergoing primary cleft operations.
• Data collected on cleft type, surgical procedure, intravenous fluid administration, time to oral feeding tolerance, and length of hospital stay.
• Comparison of outcomes between cleft lip repair, palate repair only, and lip and palate repair groups.

Main Results:

• Cleft lip repair infants had the shortest median hospital stay (25h 8min) with 33% receiving intravenous fluids.
• Infants with palate repair (alone or with lip) had longer median stays (29h 20min and 29h 0min) and higher rates of intravenous fluid administration (79% and 76%).
• Cleft lip repair infants achieved oral feeding significantly faster than those undergoing palate repair (p<0.05).

Conclusions:

• Cleft lip repair alone is associated with rapid oral feeding and minimal need for post-operative intravenous fluids.
• Cleft repairs involving the palate may lead to delayed oral feeding, potentially requiring intravenous fluids and contributing to longer hospital stays.
• Routine intravenous fluid administration post-cleft lip repair may not be necessary, but should be considered for repairs involving the palate.