Fluid, blood, and blood product management in the craniofacial patient.
This report is a retrospective review of the perioperative management of 56 children who underwent craniofacial surgical procedures. The use of a combination of 5% dextrose in normal saline or 5% dextrose in Ringer's lactate and normal saline resulted in postoperative sodium values in a normal range. In patients receiving a combination of 5% dextrose and electrolyte No. 48 and normal saline, the mean postoperative sodium level was 130 mEq/l with 9 of 18 patients below 130 mEq/l. Two patients in the series suffered clinical seizures on postoperative day 1 as a result of serum sodium levels of 122 and 121 mEq/l, respectively. We recommend that only solutions with a sodium content between 77 and 154 mEq/l be used routinely in the perioperative management of craniofacial patients.
Wilkinson
E
E
Division of Neuroanesthesiology, Barrow Neurological Institute, Phoenix, Ariz. 85013.
Rieff
J
J
Rekate
H L
HL
Beals
S
S
D000293:Adolescent; D016913:Blood Component Transfusion; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000097:blood / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000628:therapy; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies