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Scoliosis in Children: Impact of goal-directed therapies on Intraoperative and Postoperative Outcomes

Open Journal of Orthopedics 2021年第10期11卷 315-326页

作者： Claudine Kumba Lotfi Miladi Department of Pediatric and Obstetric Anesthesia and Critical Care H&ocirc pital Universitaire Necker Enfants Malades Assistance Publique H&ocirc pitaux de Paris APHP Université de Paris Paris France Department of Pediatric Orthopedic Surgery H&ocirc pital Universitaire Necker Enfants Malades Assistance Publique H&ocirc pitaux de Paris APHP Université de Paris Paris France

Background: Scoliosis is among interventions with high postoperative complication rates due to the characteristics of the surgery, where blood loss, transfusion and fluid requirements can be increased. A monocentric retrospective observational study was undertaken earlier to determine predictors of intraoperative and postoperative outcomes in surgical patients. In this initial cohort, there were patients who underwent scoliosis surgery, and a secondary analysis to describe outcomes in these patients was realized and presented here. Objective: To describe intraoperative and postoperative outcomes in patients under 18 years old in scoliosis surgery included in the initial study and to propose improvement and implementation measures. Methods: A secondary analysis of patients undergoing scoliosis surgery from

关键词： Scoliosis Children Outcome goal-directed therapies

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Postoperative Outcome in Children Aged between 6 and 10 Years in Major Abdominal Surgery, Neurosurgery and Orthopedic Surgery

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Open Journal of Pediatrics 2021年第4期11卷 636-645页

作者： Claudine Kumba Department of Pediatric Anesthesia and Critical Care Necker Enfants Malades University Hospital Assistance Publique H&ocirc pitaux de Paris APHP University of Paris Paris France

Background: Anticipating postoperative evolution in surgical patients is an important issue in our daily practice. We demonstrated in a previous study that there were multiple predictors of postoperative outcome, including American Society of Anesthesiologists status (ASA), transfusion, emergency, surgery and age. A secondary analysis describing intraoperative and postoperative outcomes was undertaken in children aged between 6 and 10 years old included in the initial study. Objective: To describe intraoperative and postoperative outcomes in children aged between 6 and 10 years old included in the initial cohort in abdominal surgery, neurosurgery and orthopedics. Methods: The secondary analysis of postoperative outcomes in children aged between 6 and 10 years old was retrospectively included in the initial study of 594 patients. The study was approved by the Ethics Committee. Results: There were 88 patients with a mean age of 98.7 ± 13.8 months. The most common surgical interventions were scoliosis in 23 patients (26.1%), limb tumor resection in 8 patients (9.1%), femoral osteotomy in 6 patients (6.8%), intracerebral tumor resection in 6 patients (6.8%), intestinal resection in 5 patients (5.6%), Chiari’s malformation in 4 patients (4.5%), pelvic osteotomy in 4 patients (4.5%) and renal transplantation in 4 patients (4.5%). Most patients (45%) were American Society of Anesthesiologists grade 3 (ASA 3), and 13 (14.8%) were ASA grade 4. Twenty-two (25%) patients had intraoperative and/or postoperative complications (organ dysfunction or sepsis). Two patients (2.3%) had intraoperative hemorrhage, 1 patient (1.1%) had intraoperative difficult intubation, and 1 patient experienced intraoperative anaphylaxis. Ni

关键词： Children Abdominal Surgery Neurosurgery Orthopedics Outcome goal-directed therapies

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