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BEBEKLERDE POSTOPERATİF HİPERGLİSEMİ, ASİDOZ, HİPOKSİ VE HİPOTERMİ

Yıl 2010, Cilt: 1 Sayı: 2, 33 - 36, 03.03.2015

Öz

Bebekler intraoperatif ve postoperatif hipotermi, hipoksi, asidoz, ve hiperglisemi riski altındadırlar. Bu komplikasyonların hepsi ayrı ayrı veya birlikte mortalite ve morbiditede etkili olabilmektedirler ve bunları hızla düzeltmek önem arzetmektedir. Bizim vakalarımızda intraoperatif hiperglisemi, hipoksi, asidoz ve hipotermisi oluşan 2 vaka incelendi. Operasyondan sonra yoğun bakımda takip edilen hastalar verilen tedavi sonrasında hızla düzeldiler. Herhangi bir sekel gözlenmedi. Sonuç olarak intraoperatif strese bağlı hiperglisemi oluşabilmektedir ve kan glukoz düzeylerinin takip edilmesi gerekmektedir. Erken kan glukoz regülasyonunun sağlanması olumlu prognoz açısından önemlidir. Hipoksi, hipotansiyon, asidoz ve hipotermi de hızla tedavi gerektiren sorunlardır. Anestezi altında özellikle uzun süren, vücüd boşluklarının açıldığı, fazla miktarda sıvı ve kan verilmesi gereken girişimlerde, daha dikkatli olunmalıdır.

Anahtar kelimeler: Postoperatif, infant, hiperglisemi, hipotermi, asidoz, hipoksi.

SUMMARY

Babies are at risk of hypothermia, hypoxia, acidosis and hyperglycemia at intraoperative and postoperative term. Since these complications can cause mortality and morbidity prompt intervention is important. In our report we present 2 cases who had intraoperative hyperglycemia, hypoxia, acidosis and hypothermia. They were followed in the intensive care unit and improved in a short time after appropriate therapy. No sequel was observed. Finally hyperglycemia can occur due to intraoperative stress and blood glucose levels should be monitored closely. Early blood glucose regulation is important for favorable prognosis. Hypoxia, hypotension, acidosis and hypothermia are also problems that need prompt intervention. One should be more careful in patients who had anesthesia for a long time, had open body cavity surgeries or received high amounts of fluid or blood during surgery.

Keywords: Postoperative, infant, hyperglycemia, hypotermia, acidosiz, hypoxemia.

Kaynakça

  • Srinavasan V, Spinella PC, Drott HR. Association of
  • Timing, Duration, and Intensity of Hyperglycemia
  • With Intensive Care Unit Mortality In Critically Ill
  • Children. Pediatr Crit Care Med 2004; 5:4.
  • Kanra G, Cengiz BA, Kara A, Melek E, Özön A.
  • Bakteriyel Menenjitli Bir Hastada Stres
  • Hiperglisemisi: Bir Vaka Takdimi. Çocuk Sağlığı ve
  • Hastalıkları Dergisi 2001; 44: 163-168.
  • Gupta P, Natarajan G, Agarwal KN. Transient
  • Hyperglycemia in Acute Childhood Illnesses to
  • Attend or Ignore? Indian J Pediatr. 1997; 64(2): 205-
  • E10s.p osito K, Marfella R, Gigliano D. Stress
  • Hyperglycemia, Inflammation and Cardiovasculer
  • Events. Diabetes Care 2003; 26: 1650-1.
  • Rabinowitz L, Joffe BI, Abkiewicz C, et al.
  • Hyperglycemia in Infantile Gastroenteritis. Arch Dis
  • Child 1984; 59: 771-775.
  • McCowen KC, Malhotra A, Bistrian BR. Stressinduced
  • Hyperglycemia. Crit Care Clin 2001; 17:
  • -124.
  • Wass CT, Lanier WL. Glucose Modulation of
  • İschemic Brain İnjury: Review and Clinical
  • Recommendations. Mayo Clin Proc 1996; 71:801-
  • -
  • Loepke AW, Spaeth JP. Glucose and Heart
  • Surgery: Neonates are not just Small Adults.
  • Anesthesiology 2004; 100:1339-1341.
  • Holliday M, Segar W. The maintenance Need for
  • Water in Parenteral Fluid Therapy. Pediatrics
  • ; 19:823-832.
  • Camboulives J. Fluid, Transfusion, and Blood
  • Sparing Techniques. Bissonnette BD, Dalens B,
  • Pediatric Anesthesia, Principles & Practice. New
  • York: McGraw-Hill; 2002. pp. 576-599.
  • Halberthal M, Halperin M, Bohn D. Acute
  • Hyponatremia in Children Admitted to Hospital:
  • Retrospective Analysis of Factors Contributing to
  • its Development and Resolution. BMJ 2001;
  • :780-782.
  • Arieff A, Ayus J, Fraser C. Hyponatraemia and
  • Death or Permanent Brain Damage in Healthy
  • Children. BMJ 1992; 304:1218-1222.
  • Arieff AI. Postoperative Hyponatraemic
  • Encephalopathy Following Elective Surgery in
  • Children. Paediatr Anaesth 1998; 8:1-4.
  • Paut O, Remond C, Lagier P, et al. Severe
  • Hyponatrenic Encephalopathy After Pediatric
  • Surgery: Report of Seven Cases And
  • Recommendations for Management And
  • Prevention Ann Fr Anesth Reanim 2000; 19:467-
  • -
  • Bohn D. Children are Another Group at Risk of
  • Hyponatraemia Perioperatively. BMJ 1999;
  • :1269.
  • Spaeth JP. Glucose and Heart surgery: Neonates
  • are not just Small Adults. Anesthesiology 2004;
  • :1339-1341.
  • Welborn LG, McGill WA, Hannallah RS, et al.
  • Perioperative Blood Glucose Concentrations in
  • Pediatric Outpatients. Anesthesiology 1986; 65:543-
  • -
  • Sandstro¨m K, Larsson LE, Nilsson K. Four
  • Different Fluid Regimes During and after Minor
  • Pediatric Surgery—a Study of Blood Glucose
  • Concentrations. Paediatr Anaesth 1994; 4:235-242.
  • Hongnat JM, Murat I, Saint-Maurice C.
  • Evaluation of current Pediatric Guidelines for
  • Fluid Therapy Using Two Different Dextrose
  • Hydrating Solutions. Paediatr Anaesth 1991; 1:95-
  • -
  • de Ferranti S, Gauvreau K, Hickey PR, et al.
  • Intraoperative Hyperglycemia During Infant
  • Cardiac Surgery is not Associated with Adverse
  • Neurodevelopmental Outcomes at 1, 4, and 8
  • Years. Anesthesiology 2004; 100:1345-1352.
  • Mikawa K, Maekawa N, Goto R, et al. Effects of
  • Exogenous Intravenous Glucose on Plasma
  • Glucose and Lipid Homeostasis in Anesthetized
  • Children. Anesthesiology 1991; 74:1017-1022
  • Larsson LE, Nilsson K, Niklasson A, et al. Influence
  • of Fluid Regimens on Perioperative blood-glucose
  • Concentrations in Neonates. Br J Anaesth 1990;
  • :419-424.
  • Nishina K, Mikawa K, Maekawa N, et al. Effects of
  • Exogenous Intravenous Glucose on Plasma
  • Glucose and Lipid Homeostasis in Anesthetized
  • Infants. Anesthesiology 1995; 83:258 263.

BEBEKLERDE POSTOPERATİF HİPERGLİSEMİ, ASİDOZ, HİPOKSİ VE HİPOTERMİ

Yıl 2010, Cilt: 1 Sayı: 2, 33 - 36, 03.03.2015

Öz

Babies are at risk of hypothermia, hypoxia, acidosis and hyperglycemia at intraoperative and postoperative term. Since these complications can cause mortality and morbidity prompt intervention is important. In our report we present 2 cases who had intraoperative hyperglycemia, hypoxia, acidosis and hypothermia. They were followed in the intensive care unit and improved in a short time after appropriate therapy. No sequel was observed. Finally hyperglycemia can occur due to intraoperative stress and blood glucose levels should be monitored closely. Early blood glucose regulation is important for favorable prognosis. Hypoxia, hypotension, acidosis and hypothermia are also problems that need prompt intervention. One should be more careful in patients who had anesthesia for a long time, had open body cavity surgeries or received high amounts of fluid or blood during surgery.

Kaynakça

  • Srinavasan V, Spinella PC, Drott HR. Association of
  • Timing, Duration, and Intensity of Hyperglycemia
  • With Intensive Care Unit Mortality In Critically Ill
  • Children. Pediatr Crit Care Med 2004; 5:4.
  • Kanra G, Cengiz BA, Kara A, Melek E, Özön A.
  • Bakteriyel Menenjitli Bir Hastada Stres
  • Hiperglisemisi: Bir Vaka Takdimi. Çocuk Sağlığı ve
  • Hastalıkları Dergisi 2001; 44: 163-168.
  • Gupta P, Natarajan G, Agarwal KN. Transient
  • Hyperglycemia in Acute Childhood Illnesses to
  • Attend or Ignore? Indian J Pediatr. 1997; 64(2): 205-
  • E10s.p osito K, Marfella R, Gigliano D. Stress
  • Hyperglycemia, Inflammation and Cardiovasculer
  • Events. Diabetes Care 2003; 26: 1650-1.
  • Rabinowitz L, Joffe BI, Abkiewicz C, et al.
  • Hyperglycemia in Infantile Gastroenteritis. Arch Dis
  • Child 1984; 59: 771-775.
  • McCowen KC, Malhotra A, Bistrian BR. Stressinduced
  • Hyperglycemia. Crit Care Clin 2001; 17:
  • -124.
  • Wass CT, Lanier WL. Glucose Modulation of
  • İschemic Brain İnjury: Review and Clinical
  • Recommendations. Mayo Clin Proc 1996; 71:801-
  • -
  • Loepke AW, Spaeth JP. Glucose and Heart
  • Surgery: Neonates are not just Small Adults.
  • Anesthesiology 2004; 100:1339-1341.
  • Holliday M, Segar W. The maintenance Need for
  • Water in Parenteral Fluid Therapy. Pediatrics
  • ; 19:823-832.
  • Camboulives J. Fluid, Transfusion, and Blood
  • Sparing Techniques. Bissonnette BD, Dalens B,
  • Pediatric Anesthesia, Principles & Practice. New
  • York: McGraw-Hill; 2002. pp. 576-599.
  • Halberthal M, Halperin M, Bohn D. Acute
  • Hyponatremia in Children Admitted to Hospital:
  • Retrospective Analysis of Factors Contributing to
  • its Development and Resolution. BMJ 2001;
  • :780-782.
  • Arieff A, Ayus J, Fraser C. Hyponatraemia and
  • Death or Permanent Brain Damage in Healthy
  • Children. BMJ 1992; 304:1218-1222.
  • Arieff AI. Postoperative Hyponatraemic
  • Encephalopathy Following Elective Surgery in
  • Children. Paediatr Anaesth 1998; 8:1-4.
  • Paut O, Remond C, Lagier P, et al. Severe
  • Hyponatrenic Encephalopathy After Pediatric
  • Surgery: Report of Seven Cases And
  • Recommendations for Management And
  • Prevention Ann Fr Anesth Reanim 2000; 19:467-
  • -
  • Bohn D. Children are Another Group at Risk of
  • Hyponatraemia Perioperatively. BMJ 1999;
  • :1269.
  • Spaeth JP. Glucose and Heart surgery: Neonates
  • are not just Small Adults. Anesthesiology 2004;
  • :1339-1341.
  • Welborn LG, McGill WA, Hannallah RS, et al.
  • Perioperative Blood Glucose Concentrations in
  • Pediatric Outpatients. Anesthesiology 1986; 65:543-
  • -
  • Sandstro¨m K, Larsson LE, Nilsson K. Four
  • Different Fluid Regimes During and after Minor
  • Pediatric Surgery—a Study of Blood Glucose
  • Concentrations. Paediatr Anaesth 1994; 4:235-242.
  • Hongnat JM, Murat I, Saint-Maurice C.
  • Evaluation of current Pediatric Guidelines for
  • Fluid Therapy Using Two Different Dextrose
  • Hydrating Solutions. Paediatr Anaesth 1991; 1:95-
  • -
  • de Ferranti S, Gauvreau K, Hickey PR, et al.
  • Intraoperative Hyperglycemia During Infant
  • Cardiac Surgery is not Associated with Adverse
  • Neurodevelopmental Outcomes at 1, 4, and 8
  • Years. Anesthesiology 2004; 100:1345-1352.
  • Mikawa K, Maekawa N, Goto R, et al. Effects of
  • Exogenous Intravenous Glucose on Plasma
  • Glucose and Lipid Homeostasis in Anesthetized
  • Children. Anesthesiology 1991; 74:1017-1022
  • Larsson LE, Nilsson K, Niklasson A, et al. Influence
  • of Fluid Regimens on Perioperative blood-glucose
  • Concentrations in Neonates. Br J Anaesth 1990;
  • :419-424.
  • Nishina K, Mikawa K, Maekawa N, et al. Effects of
  • Exogenous Intravenous Glucose on Plasma
  • Glucose and Lipid Homeostasis in Anesthetized
  • Infants. Anesthesiology 1995; 83:258 263.
Toplam 87 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Case Report
Yazarlar

Murat Tutanç Bu kişi benim

Vefik Arıca Bu kişi benim

Fatmagül Başarslan Bu kişi benim

Murat Karcıoğlu Bu kişi benim

Işıl Davarcı Bu kişi benim

Kasım Tuzcu Bu kişi benim

Tanju Çelik Bu kişi benim

Emre Ayıntap Bu kişi benim

Yayımlanma Tarihi 3 Mart 2015
Gönderilme Tarihi 2 Mart 2015
Yayımlandığı Sayı Yıl 2010 Cilt: 1 Sayı: 2

Kaynak Göster

Vancouver Tutanç M, Arıca V, Başarslan F, Karcıoğlu M, Davarcı I, Tuzcu K, Çelik T, Ayıntap E. BEBEKLERDE POSTOPERATİF HİPERGLİSEMİ, ASİDOZ, HİPOKSİ VE HİPOTERMİ. mkutfd. 2015;1(2):33-6.