Pediatrik Nöroanestezide Sıvı Tedavisi

Nöroşirürjik işlemlerdepediatrik hastaların perioperatif sıvı yönetimi, pediatrik vakaların farklı patofizyolojileri, sıvı kaybına duyarlılıkları, olası problemlerin (aşırı antidiüretik hormon salgılanması, serebral tuz kaybettiren sendrom vs.) teşhisindeki sorunlar ve monitörizasyondaki kısıtlılıklar dolayısıyla özel dikkat gerektirir. Operasyon geçirecek hastada sıvı tedavisi, sıvı eksikliğini yerine koymak, idame sıvı gereksinimlerini karşılamak, yeterli doku perfüzyonunu sağlamak ve anestetiklerin istenmeyen etkilerini azaltmak amaçlarını içermelidir.

Anahtar Kelimeler:

Nöroanestezi, nöroşirürji, pediatri

Complicatıons in Percutaneous Nephrolithotomy and Management

Kidney stone disease is very common in the world. Although percutaneous nephrolithotomy (PCNL) is the gold standard surgical treatment for renal stones larger than 2 cm, complication rates of 20% to 83% have been reported. Complications of PCNL procedure include bleeding, sepsis, injury to the collecting system, injury to adjacent organs such as colon, small intestine, thoracic, liver, gallbladder and spleen, and death. These complications are minimized by choosing an appropriate patient and good preoperative evaluations. As experience increases, the complication rate decreases. The most important is the early identification of the complication. Major complications can be solved with conservative and minimally invasive methods. In this review, we discussed the complications and their management of PCNL.

Keywords:

Kidney Kidney Stone, Percutanous Nephrolithotomy, Complication,

PDF

___

1. Hellerstein S. Fluid and electrolytes: clinical aspects. Pediatr Rev. 1993;14:103-15.
2. Flaherman VJ, Schaefer EW, Kuzniewicz MW, et al. Early weight loss nomograms for exclusively breastfed newborns. Pediatrics. 2015;135:e16-23.
3. Dell KR. Fluid, electrolytes, and acid-base homeostasis. Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin's Neonatal-Perinatal Medicine E-Book: Diseases of the Fetus and Infant. Elsevier Mosby, St. Louis 2011. Vol 1, p.669.
4. Chawla D, Agarwal R, Deorari AK, et al. Fluid and electrolyte management in term and preterm neonates. Indian J Pediatr. 2008;75(3):255-9.
5. Rasouli M, Kalantari KR. Comparison of methods for calculating serum osmolality: multivariate linear regression analysis. Clin Chem Lab Med. 2005;43:635-40.
6. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th ed, McGraw-Hill, New York 2001. p.441.
7. Intravenous fluid therapy in children and young people in hospital NICE guideline, December 2015 N29. Avaliable from:https://www.nice.org.uk/guidance/ng29/resources/intravenous-fluid-therapy-in-children-and-young-people-in-hospital-1837340295109 Erişim tarihi: 15 Mayıs 2019.
8. Vega RM, Avva U. Pediatric Dehydration. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436022/ Erişim tarihi: 15 Mayıs 2019.
9. An Updated Report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiol. 2011;114:495–511.
10. Sumpelmann R, Becke K, Brenner S, et al. Perioperative intravenous fluid therapy in children: guidelines from the Association of the Scientific Medical Societies in Germany. Paediatr Anaesth. 2017;27:10-18.
11. Welborn L, McGill W, Hannallah R, et al. Perioperative blood glucose concentrations in pediatric outpatients. Anesthesiol. 1986;65:543–7.
12. Nishina K, Mikawa K, Maekawa N, et al. Effects of exogenous intravenous glucose on plasma glucose and lipid homeostasis in anesthetized infants. Anesthesiol. 1995;83:258-63.
13. Sandstro¨m K, Larsson LE, Nilsson K. Four different fluid regimes during and after minor paediatric surgery—a study of blood glucose concentrations. Paediatr Anaesth. 1994;4:235-42.
14. Hongnat JM, Murat I, Saint-Maurice C. Evaluation of current paediatric guidelines for fluid therapy using two different dextrose hydrating solutions. Paediatr Anaesth. 1991;1:95-100.
15. Larsson LE, Nilsson K, Niklasson A, et al. Influence of fluid regimens on perioperative blood-glucose concentrations in neonates. Br J Anaesth. 1990;64:419-24.
16. Anand KJ, Brown MJ, Causon RC, et al. Can the human neonate mount an endocrine and metabolic response to surgery? J Pediatr Surg. 1985;20:41–8.
17. Anand KJ, Brown MJ, Bloom SR, et al. Studies on the hormonal regulation of fuel metabolism in the human newborn infant undergoing anaesthesia and surgery. Horm Res. 1985;22:115–28.
18. Anand KJ, Hansen DD, Hickey PR. Hormonal- metabolic stress responses in neonates undergoing cardiac surgery. Anesthesiol. 1990;73:661–70.
19. Hays SP, Smith EO, Sunehag AL. Hyperglycemia is a risk factor for early death and morbidity in extremely low birthweight infants. Pediatrics. 2006;118:1811–8.
20. Blanco CL, Baillargeon JG, Morrison RL, et al. Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities. J Perinatol. 2006;26 737–41.
21. Heimann K, Peschgens T, Kwiecien R, et al. Are recurrent hyperglycemic episodes and median blood glucose level a prognostic factor for increased morbidity and mortality in premature infants ≤ 1500 g? J Perinat Med. 2007;35:45–8.
22. Vavilala MS, Soriano SG. Anesthesia for Neurosurgery. In: Smith's Anesthesia for Infants and Children, by Moosby 2011; Chapter 22; 713-44.
23. Wass CT, Lanier WL. Glucose modulation of ischemic brain injury: review and clinical recommendations. Mayo Clin Proc. 1996;71:801-12.
24. Feld LG, Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018;142.
25. Arya VK. Basics of fluid and blood transfusion therapy in paediatric surgical patients. Indian J Anaesth. 2012;56:454‑62.
26. Friedman AL. Pediatric hydration therapy: historical review and a new approach. Kidney Int. 2005;67:380-8.
27. Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19:823-32.
28. Taylor D, Durward A. Pouring salt on troubled waters. Arch Dis Child. 2004;89:411-4.
29. Lindahl SG. Energy expenditure and fluid and electrolyte requirements in anesthetized infants and children. Anesthesiol. 1988;69(3):377-82.
30. Weed LH, McKibben PS. Pressure changes in the cerebro-spinal fluid following intravenous injection of solutions of various concentrations. Am J Physiol. 1919;48:512–30.
31. Allen CH, Goldman RD, Bhatt S, et al. A randomized trial of Plasma‑Lyte A and 0.9% sodium chloride in acute pediatric gastroenteritis. BMC Pediatr. 2016;16:117.
32. Houghton J, Wilton N. Choice of isotonic perioperative fluid in children. Anesth Analg. 2011;112:246‑7.
33. Judd BA, Haycock GB, Dalton RN, et al. Antidiuretic hormone following surgery in children. Acta Pædiatrica. 1990;79(4):461-6.
34. Sterns RH, Silver SM. Complications and management of hyponatremia. Curr Opin Nephrol Hypertens.2016;25:114-9.
35. Choong K, Kho ME, Menon K, et al. Hypotonic versus isotonic saline in hospitalised children: a systematic review. Arch Dis Child. 2006;91(10):828-35.
36. McNab S, Duke T, South M, et al. 140 mmol/L of sodium versus 77 mmol/L of sodium in maintenance intravenous fluid therapy for children in hospital (PIMS): a randomised controlled double-blind trial. Lancet. 2015;385(9974):1190-7.
37. Neville KA, Sandeman DJ, Rubinstein A, et al. Prevention of hyponatremia during maintenance intravenous fluid administration: a prospective randomized study of fluid type versus fluid rate. J Pediatr. 2010;156:313-9.
38. Goobie SM, Haas T. Bleeding management for pediatric craniotomies and craniofacial surgery. Pediatr Anesth. 2014; 24:678–89.
39. McCluskey SA, Karkouti K, Wijeysundera D, et al. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study. Anesth Analg. 2013;117:412–21.
40. Fraser JF, Stieg PE. Hyponatremia in the neurosurgical patient: epidemiology, pathophysiology, diagnosis, and management. Neurosurg. 2006;59:222-9.
41. Palmer BF. Hyponatremia in patients with central nervous system disease: SIADH versus CSW. Trends Endocrinol Metab. 2003;14(4):182-7.
42. Hardesty DA, Kilbaugh TJ, Storm PB. Cerebral Salt Wasting Syndrome in Post-Operative Pediatric Brain Tumor Patients. Neurocrit Care. 2012;17:382–7.
43. Berkenboscha JW, Lentz CW, Jimenez DF, et al. Cerebral salt wasting syndrome following brain injury in three pediatric patients: Suggestions for rapid diagnosis and therapy. Pediatr Neurosurg. 2002;36:75-9.
44. Karnik HS. Fluid management in infants and children during intracranial surgery. Journal of Neuroanaesthesiology and Critical Care. 2017;4 (Supp 1):S24-9.
45. Knapp JM. Hyperosmolar therapy in the treatment of severe head injury in children: mannitol and hypertonic saline. AACN Clin Issues. 2005;16:199-211.
46. Sorani MD, Manley GT. Dose-response relationship of Mannitol and intracranial pressure: a metaanlysis. J Neurosurg. 2008;108:80-7.
47. Yanko J, Mitcho K. Acute care management of severe traumatic brain injuries. Crit Care Nurs Quart. 2001;4:1–23.
48. Sunit CS, Lokesh T. Management of intracranial hypertension. Indian J Pediatr. 2009;76:519-29.
49. Jankowitz BT, Adelson PD. Pediatric traumatic brain injury: past, present and future. Dev Neurosci. 2006;28(4-5), 264-75.
50. Llorente G, de Mejia MCN. Mannitol versus hypertonic saline solution in neuroanaesthesia. Colomb J Anesthesiol. 2015;43(S1):29-39.
51. Berger S, Schurer L, Hartl R, et al. Reduction of post-traumatic intracranial hypertension by hypertonic/hyperoncotic saline/dextran and hypertonic mannitol. Neurosurg. 1995;1:98–107.
52. Mirski M, Drenchev D, Schnitzer M, et al. Comparison between hypertonic saline and mannitol in the reduction of elevated intracranial pressure in a rodent model of acute cerebral injury. J Neurol Anesthes. 2000;4:334–44.
53. Qureshi A, Wilson D, Traytsman R. Treatment of Elevated Intracranial Pressure in Experimental Intracerebral Hemorrhage: Comparison Between Mannitol and Hypertonic Saline. Neurosurg. 1999;5:1055–63.
54. Horn P, Munch E, Vajkoczy P, et al. Hypertonic saline solution for control of elevated intracranial pressure in patients with exhausted response to mannitol and barbiturates. Neurolog Res. 1999;21:758–64.
55. Schwarz S, Schwab S, Bertram M, et al. Effects of hypertonic saline hydroxyethyl starch solution and mannitol in patients with increased intracranial pressure after stroke. Stroke. 1998;29(8):1055–63.
56. Vialet R, Albanese J, Thomachot L, et al. Isovolume hypertonic solutes (sodium chloride or mannitol) in the treatment of refractory posttraumatic intracranial hypertension: 2 ml/kg 7.5% saline is more effective than 2 ml/kg 20% mannitol. Crit Care Med. 2003;31(6):1683–7.
57. Doyle J, Davis D, Hoyt D. The use of hypertonic saline in the treatment of traumatic brain injury. J Trauma Inj Inf Crit Care. 2001;2:367–83.
58. Suarez J, Qureshi A, Bhardwaj A, et al. Treatment of refractory intracranial hypertension with 23.4% saline. Crit Care Med. 1998;26(6):1118–22.
59. Peterson B, Khanna S, Fisher B, et al. Prolonged hypernatremia controls elevated intracranial pressure in head-injured pediatric patients. Crit Care Med. 2000;4:1136-43.
60. Khanna S, Davis D, Peterson B, et al. Use of hypertonic saline in the treatment of severe refractory posttraumatic intracranial hypertension in pediatric traumatic brain injury. Crit Care Med. 2000;4:1144–51.
61. Ali Z, Prabhakar H. Fluid management during neurosurgical procedures. J Neuroanaesth Crit Care. 2016;3 Suppl S1:S35‑40.
62. Ogden AT, Mayer SA, Connolly S. Hyperosmolar agents in neurosurgical practice: the evolving role of hypertonic saline. Neurosurg. 2005;57:207-15.
63. Qureshi A, Suarez J. Use of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension. Crit Care Med. 2000;9:3301–13.
64. Kamel H, Navi BB, Nakagawa K, et al. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med. 2011;39(3):554-9.
65. Gan H, Cannesson M, Chandler JR, et al. Predicting fluid responsiveness in children: A systematic review. Anesth Analg. 2013;117:1380‑92.