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Muszynski, J.A., Spinella, P.C., Cholette, J.M., Acker, J.P., Hall, M.W., Juffermans, N.P., et al. (2016) Transfusion-Related Immunomodulation: Review of the Literature and Implications for Pediatric Critical Illness. Transfusion, 57, 195-206.
https://doi.org/10.1111/trf.13855

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• TITLE: Neuroblastoma in Children: Intraoperative Goal Directed Therapy, Intraoperative and Postoperative Outcomes

  AUTHORS: Claudine Kumba

  KEYWORDS: Neuroblastoma, Children, Intraoperative Goal Directed Therapies, Postoperative Outcomes

  JOURNAL NAME: Open Journal of Internal Medicine, Vol.11 No.4, December 3, 2021

  ABSTRACT: 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 broncho-laryngospasm 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. 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.