Monitoring the metabolic response to major surgery in neonates.
BACKGROUND
Visceral proteins and acute phase reactants have commonly been used as indicators of nutritional status, and metabolic response of surgical trauma.


OBJECTIVE
This study was undertaken to determine how some plasma proteins, alone or together reflect metabolic response in neonates recovering from major surgery.


METHODS
Serum albumin, pre-albumin (PA), C-reactive protein (CRP), and alpha1-acid glycoprotein (AGP) levels were measured, and the prognostic inflammatory and nutritional index (PINI) was calculated for preoperative day 1 (-1) and postoperative (PO) days 1 (+1) and 7 (+7).


RESULTS
PA, CRP, AGP and PINI were significantly different on day +1 from day -1. While AGP and PINI were still significantly higher than that of day -1, PA and CRP returned to the preoperative levels on day +7.


CONCLUSIONS
PA, CRP and AGP measurements are superior to PINI for assessing postoperative metabolic changes in term neonates following uncomplicated major surgery on early and late phase. But this comparison must be performed in the management of more complex cases to determine which one is better to indicate morbidity and mortality.
Caglayan
F
F
Department of Pediatric Surgery, Medical Faculty, Kirikkale University, 71100 Kirikkale, Turkey. fatmacaglayan@yahoo.com
Caglayan
O
O
Gunel
E
E
Sahin
T K
TK
D000768:Anesthesia, General; D001798:Blood Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D013312:Stress, Physiological; D013514:Surgical Procedures, Operative
D001798:Blood Proteins