caa a22 4500 606214437 CHVBK 20210128101053.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00701-015-2441-5 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2441-5 Metabolic changes and factors influencing base deficit in infants undergoing craniosynostosis surgery: a retrospective study [Elektronische Daten] [Achmet Ali, Burcu Basaran, Gamze Tanirgan, Aydin Aydoseli, Pulat Sabanci, Altay Sencer, Lutfi Telci, Ibrahim Akinci] Background: Corrective craniosynostosis surgery is often associated with a large amount of blood loss and metabolic disturbances. In the present study, we investigated the severity, duration of metabolic disturbances, and causal risk factors in infants. Methods: A retrospective analysis was performed of 36 infants who underwent craniosynostosis surgery. We analyzed the following: demographics, duration of surgery, intraoperative blood loss, RBC, FFP and fluids transfused, urine output, hemodynamic parameters, and electrolyte and base deficit (BD) values. The lowest intraoperative BD value and time required (period I: <6h; period II: 6-12h; period III: >12h) for BD values to return to normal (-4 to +2) in the postoperative period were determined. In addition, we recorded the postoperative length of stay in the ICU and hospital, postoperative blood loss, and early complications. Results: We detected that 88% of the patients had subnormal BD levels and 22% had metabolic acidosis. The lowest average BD measured during the operation was -8.4 ± 2.6mmol/l. We carried out a multiple regression analysis, which revealed that lower BD values were associated with a longer duration of hypotension (p = 0.002, R2 = 0.453) and greater intraoperative blood loss (p = 0.002, R2 = 0.674). We examined the amount of intraoperative blood loss and found that that there were fewer blood product transfusions in period I patients and longer hypotensive episodes in period III patients. Also, a negative correlation was detected between the lowest intraoperative BD value with ICU duration (p = 0.004, r = -0.466) and hospital stay (p < 0.001, r = -0.764). Conclusion: Almost all patients developed intraoperative negative BD, which was prolonged in the postoperative period. The most important risk factors for developing negative BD are the amount of blood loss and duration of hypotension. Springer-Verlag Wien, 2015 Acid-base imbalance nationallicence Craniosynostoses nationallicence Fluid balance nationallicence Neuroanaesthesia nationallicence Surgical blood loss nationallicence Ali Achmet Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut Basaran Burcu Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut Tanirgan Gamze Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut Aydoseli Aydin Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut Sabanci Pulat Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut Sencer Altay Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut Telci Lutfi Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut Akinci Ibrahim Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1197-1204 0001-6268 157:7<1197 2015 157 701 https://doi.org/10.1007/s00701-015-2441-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2441-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ali Achmet Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Basaran Burcu Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Tanirgan Gamze Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Aydoseli Aydin Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Sabanci Pulat Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Sencer Altay Istanbul Medical Faculty, Department of Neurosurgery, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Telci Lutfi Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Akinci Ibrahim Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation Fatih, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1197-1204 0001-6268 157:7<1197 2015 157 701