Elektif Konjenital Kalp Cerrahisi Geçirecek Çocuk Hastaların Preoperatif Nütrisyonel Durumunun Postoperatif Morbidite ve Mortalite Üzerine Etkisi

Abstract

Malnutrition is one of the most important morbidity factor in pediatric intensive care units (PICU). Assessing the preoperative nutritional status in children undergoing surgery prevents the occurance of morbidity factors commonly seen in postoperative period. In this study, 36 children, between 3 months - 5 years of age, undergoing elective cardiac surgery included. Nutritional status of all patients are assessed with Triceps Skinfold Thickness Z score as an antropometric measurement method of nutrition and albumin and prealbumin as biomarkers. These markers of nutritional status corrolated with lenght of stay in PICU , duration of mechanical ventilation and need for inotropic medications which are postoperative morbidity factors of intensive care unit. There was no correlation between, makers of preoperative nutritional status and postoperative factors of morbidity (p>0.05). Beside, there was not any meaningful relation between preoperative markers of nutritional status and 30 days of in hospital mortality (p>0,05). Brain Natriuretic Peptid as a biomarker of myocardial stress was related to the preoperative markers of nutritional status. No corelation has been found as well (p>0,05). Last, any corrolation between Pediatric Risk of Mortality (PRISM) as one of the mortality scoring system of PICU and all preoperative variables of nutritional status and myocardial stress has been asked. No statistically meaningful relation has not been found in between (p>0,05). In conclusion, according to this study , there is not any effect of preoperative nutritional status on postoperative mortality and morbidity in children undergoing elective congenital heart surgery. Beside, the realibility of postoperative mortality scoring system is poor in these patients.That's why, contradiction to the literature, there is a great need for new, comprehensive studies design prospectively.