Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA.
Pediatr Crit Care Med. 2010 Nov;11(6):718-22. doi: 10.1097/PCC.0b013e3181d907fa.
To describe the pediatric intensive care unit (PICU) course and resource utilization for children with brain tumor resection and to identify factors predicting prolonged (>1 day) PICU length of stay. After craniotomy for brain tumor resection, children recover in the PICU. A few require critical care interventions and a >24-hr length of stay.
We reviewed all brain tumor resection patients admitted to the PICU over 2 yrs. Preoperative, intraoperative, and postoperative variables and tumor characteristics were examined. The extracted variables were compared between two groups with a length of stay in the PICU of >1 or <1 day.
Pediatric intensive care unit in a tertiary academic children's medical center.
A total of 105 patients post brain tumor resection were admitted to the PICU over the study period and analyzed.
Record review.
Thirty-two (31%) of 105 patients remained in the PICU for >1 day. The mean age of patients in the >1 day group was 5.0 ± 0.81 yrs and 8.78 ± 0.65 yrs in the <1 day group (p < .05). The estimated blood loss was 20 ± 2.37 mL/kg in the >1 day and 9 ± 0.92 mL/kg in the <1 day group (p < .05). Fifteen (14.3%) patients were mechanically ventilated on arrival in the PICU; these patients more often had a length of stay of >1 day (p < .05). The number of unexpected intensive care unit interventions were 0.7 per patient, were more common in the >1 day group, and included treatment of sodium abnormalities, new neurologic deficits, paresis, or seizures (p < .05). In a logistic regression model, estimated blood loss and intubation on arrival predicted longer lengths of stay in the PICU (odds ratio, 1.1; 95% confidence interval, 1.05-1.18; and odds ratio, 33; 95% confidence interval, 2.57-333, respectively), with a receiver operating characteristic curve of 0.86 and 95% confidence interval, 0.78-0.94.
Large intraoperative estimated blood loss and intubation on arrival may be predictive of PICU lengths of stay of >1 day for children who have had a craniotomy for brain tumor resection. Intensive care unit interventions are more common in these children.
描述脑肿瘤切除术后患儿在儿科重症监护病房（PICU）的病程和资源利用情况，并确定预测 PICU 住院时间延长（>1 天）的因素。脑肿瘤切除术后，患儿在 PICU 恢复。少数患儿需要重症监护干预和>24 小时的住院时间。
我们回顾了过去 2 年中所有在 PICU 接受脑肿瘤切除术的患儿。检查了术前、术中及术后变量和肿瘤特征。对两组患儿进行了比较，一组患儿在 PICU 的住院时间>1 天，另一组<1 天。
在一家三级学术儿童医院的儿科重症监护病房。
在研究期间，共有 105 例脑肿瘤切除术后患儿被收入 PICU 并进行了分析。
记录回顾。
32 例（31%）患儿在 PICU 住院时间>1 天。>1 天组患儿的平均年龄为 5.0±0.81 岁，<1 天组为 8.78±0.65 岁（p<0.05）。>1 天组患儿的估计失血量为 20±2.37ml/kg，<1 天组为 9±0.92ml/kg（p<0.05）。15 例（14.3%）患儿在入 PICU 时即需要机械通气，这些患儿的住院时间延长>1 天的可能性更高（p<0.05）。>1 天组患儿更常出现 0.7 次/例的意外 ICU 干预，包括治疗钠异常、新的神经功能缺损、瘫痪或癫痫发作（p<0.05）。在逻辑回归模型中，估计的失血量和入 PICU 时的插管预测了 PICU 住院时间的延长（比值比，1.1；95%置信区间，1.05-1.18；比值比，33；95%置信区间，2.57-333），受试者工作特征曲线的 95%置信区间为 0.78-0.94。
术中估计失血量较大和入 PICU 时插管可能预测行开颅术治疗脑肿瘤的患儿 PICU 住院时间>1 天。这些患儿更常需要 ICU 干预。
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