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Evaluating a standardized protocol for the management of diabetes insipidus in pediatric neurosurgical patients.
Mak, Daniel; Schaller, Alexandra L; Storgion, Stephanie A; Lahoti, Amit.
Afiliación
  • Mak D; Department of Pediatrics, Division of Endocrinology, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Professional Building 3, 1900 Maryland Ave, Little Rock, AR 72202G-4016-1, USA.
  • Schaller AL; Department of Pediatrics, Division of Critical Care Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA.
  • Storgion SA; Department of Pediatrics, Division of Critical Care Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA.
  • Lahoti A; Department of Pediatrics, Division of Endocrinology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
J Pediatr Endocrinol Metab ; 35(2): 197-203, 2022 Feb 23.
Article en En | MEDLINE | ID: mdl-34563107
OBJECTIVES: Central diabetes insipidus (DI) is a known complication following surgical resection of a suprasellar mass. There are limited data analyzing the outcomes of a standardized protocol for the management of postoperative DI in the pediatric population. We sought to fill this gap and hypothesized that utilizing a standardized protocol for fluid management (3-bag system) would reduce serum sodium fluctuations in the postoperative period after suprasellar surgery. METHODS: A retrospective chart review was performed. Patients were identified with the following criteria: age ≤ 18 years, undergoing a surgical procedure for suprasellar mass that also had postoperative DI. The primary outcome was the variability in serum sodium during the first 48 h and between 48 and 120 h postoperatively. RESULTS: There were 21 encounters pre-protocol and 22 encounters post-protocol for neurosurgical procedures. Use of the standardized protocol was associated with a lower range of sodium within 48 h postoperatively (p=0.065) and 83% lower odds of hypernatremia (Na>150 mmol/L) within 48 h postoperatively (CI 0.039-0.714) after controlling for age, gender, and prior DI diagnosis. History of DI conferred a lower risk of hypernatremia as well as less sodium fluctuation within 48 h postoperatively. Younger patients, those <9.7 years of age were associated with increased risk of hyponatremia and greater sodium fluctuations during the postoperative period. CONCLUSIONS: In patients with postoperative DI after suprasellar surgery, using a standardized protocol for fluid management (3-bag system) appears to reduce serum sodium variability in the first 48 h after surgery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos Neuroquirúrgicos / Diabetes Insípida Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Pediatr Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos Neuroquirúrgicos / Diabetes Insípida Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Female / Humans / Male Idioma: En Revista: J Pediatr Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / PEDIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania