title: Monitoring the metabolic response to major surgery in neonates.
abstract: 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.
authors.affiliation: Department of Pediatric Surgery, Medical Faculty, Kirikkale University, 71100 Kirikkale, Turkey. fatmacaglayan@yahoo.com
authors.forename: F
authors.initials: F
authors.lastname: Caglayan
authors.forename: O
authors.initials: O
authors.lastname: Caglayan
authors.forename: E
authors.initials: E
authors.lastname: Gunel
authors.forename: T K
authors.initials: TK
authors.lastname: Sahin
mesh_terms: D000768:Anesthesia, General; D001798:Blood Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D013312:Stress, Physiological; D013514:Surgical Procedures, Operative
chemical_list: D001798:Blood Proteins