Anesthetic management of an infant with giant abdominal neuroblastoma

2021

Preprint

Background: Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization and catecholamine-secreting characteristics of the tumor. We undertook a secondary analysis in a previous study to describe patients who underwent neuroblastoma resection.Objective: To describe intraoperative and postoperative outcomes in patients who underwent neuroblastoma resection and to propose optimal intraoperative management for postoperative outcome improvement.Methods: This was a secondary analysis of children who underwent neuroblastoma resection in the initial retrospective study.Results: There were 16 patients with a mean age of 39.3±22.1 months. Seven (43.8%) patients presented with intraoperative or postoperative complications. One (6.3%) patient had intraoperative broncholaryngospasm and difficult intubation. Two (12.5%) patients had intraoperative hemorrhagic shock. One patient (6.3%) had postoperative renal failure. Two patients (12.5%) had postoperative respiratory failure, and 3 (18.8%) patients had postoperative cardiocirculatory failure. One (6.3%) had postoperative pulmonary sepsis and septicemia. Thirteen (81.3%) patients were intraoperatively transfused. There was no in-hospital mortality.Conclusion: In this cohort, 43.8% of the patients had intraoperative and/or postoperative complications in terms of organ dysfunction or sepsis. A total of 81.3% of the patients received intraoperative transfusion. Neuroblastoma surgery can be a challenging situation where cardiovascular instability, high blood loss and transfusion requirements can be encountered. Consequently, preoperative preparation and optimal intraoperative management with validated tools in children could be necessary for a better postoperative outcome in this surgical setting.

“…The median LOSICU was 7[0-16] days. The median LOS was 8.5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] days. The median TLOS was 15 days.…”

Section: Table 1 Illustrates General Characteristicsmentioning

confidence: 99%

Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative And Postoperative Outcomes

2021

Preprint

“…The median length of intensive care unit stay (LOSICU) was 7[0-16] days. The median length of hospital stay in the conventional ward (LOS) was 8.5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] days. The median total length of hospital stay (TLOS=LOSICU+LOS) was 15 days.…”

Section: Table 1 Illustrates General Characteristicsmentioning

confidence: 99%

“…Neuroblastoma is the most common tumor in children with an incidence of 10.2 per million children under 15 years old and is responsible of 13-15% of deaths due to cancer in children (1,2,3,4). Long term prognosis depends on the characteristics of the tumor with ve year survival in low risk and high risk neuroblastoma varying from 90-95% to 40-50% respectively (2,5).…”

Section: Introductionmentioning

confidence: 99%

Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative And Postoperative Outcomes

2021

Preprint

Background Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization, catecholamine-secreting characteristic of the tumor. We undertook a secondary analysis in a previously study to describe patients who underwent neuroblastoma resection. Objective To describe intraoperative and postoperative outcomes in patients who underwent neuroblastoma resection and to propose optimal intraoperative management for postoperative outcome improvement. Methods Secondary analysis of children who had neuroblastoma resection in the initial retrospective study. Results There were 16 patients with a mean age of 39.3±22.1 months. Seven (43.8%) patients presented with intraoperative or postoperative complications. One (6.3%) patient had intraoperative broncho-laryngospasm and difficult intubation respectively. Two (12.5%) patients had intraoperative hemorrhagic shock. One patient (6.3%) had postoperative renal failure. Two patients (12.5%) had postoperative respiratory failure and 3 (18.8%) patients had postoperative cardiocirculatory failure. One (6.3%) had postoperative pulmonary sepsis and septicemia respectively. Thirteen (81.3%) patients were intraoperatively transfused. There was no in-hospital mortality. Conclusion Neuroblastoma surgery can be a challenging situation where cardiovascular instability, high blood loss and transfusion requirements can be encountered. Consequently, preoperative preparation, intraoperative optimal management with validated means in children are necessary for a better postoperative outcome in this surgical setting.

“…Neuroblastoma is the most common tumor in children, with an incidence of 10.2 per million children under 15 years old, and is responsible for 13-15% of deaths due to cancer in children (1,2,3,4). Long-term prognosis depends on the characteristics of the tumor, with ve-year survival in low-risk and high-risk neuroblastoma varying from 90-95% to 40-50%, respectively (2,5).…”

Section: Introductionmentioning

confidence: 99%

Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative And Postoperative Outcomes

2021

Preprint

Background: Neuroblastoma is the most common tumor in children. Anesthetic management can be challenging due to the localization and catecholamine-secreting characteristics of the tumor. We undertook a secondary analysis in a previous study to describe patients who underwent neuroblastoma resection.Objective: To describe intraoperative and postoperative outcomes in patients who underwent neuroblastoma resection and to propose optimal intraoperative management for postoperative outcome improvement.Methods: This was a secondary analysis of children who underwent neuroblastoma resection in the initial retrospective study.Results: There were 16 patients with a mean age of 39.3±22.1 months. Seven (43.8%) patients presented with intraoperative or postoperative complications. One (6.3%) patient had intraoperative broncholaryngospasm and difficult intubation. Two (12.5%) patients had intraoperative hemorrhagic shock. One patient (6.3%) had postoperative renal failure. Two patients (12.5%) had postoperative respiratory failure, and 3 (18.8%) patients had postoperative cardiocirculatory failure. One (6.3%) had postoperative pulmonary sepsis and septicemia. Thirteen (81.3%) patients were intraoperatively transfused. There was no in-hospital mortality.Conclusion: Neuroblastoma surgery can be a challenging situation where cardiovascular instability, high blood loss and transfusion requirements can be encountered. Consequently, preoperative preparation and optimal intraoperative management with validated means in children are necessary for a better postoperative outcome in this surgical setting.