PhD Scientific Days 2025

Poster Session III. - X: Conservative Medicine

Perioperative Homeostasis Changes in Neonates

Name of the presenter

Pal Vanda

Institute/workplace of the presenter

Semmelweis University Pediatric Center

Authors

Vanda Pal¹, Zsofia Varga², Luca Bogner³, Balazs Hauser⁴, Agnes Jermendy¹

1: Semmelweis University Pediatric Center
2: Semmelweis University Faculty of Medicine
3: Semmelweis University Doctoral College
4: Semmelweis University Department of Anesthesiology

Text of the abstract

Introduction

Maintaining physiological homeostasis in neonates undergoing high-risk procedures requiring anesthesia is crucial. Blood pressure, diuresis and blood gas changes are important markers of homeostatic changes in the perioperative period.

Aims

We aimed to examine perioperative physiological changes in neonates undergoing procedures requiring anesthesia.

Methods

We conducted a prospective observational study between 2021 and 2024 at Semmelweis University Pediatric Center’s Bókay street division on neonates undergoing surgery, weighing less than 6 kgs. We collected our participants’ data retrospectively from hand-written patient charts on diuresis (ml/kg/h), blood gas parameters and mean arterial pressure (MAP) in the pre- and postoperative 6-12 hour periods.

Results

We collected perioperative data on 26 of our 199 study participant. Median [IQR] gestational age was 37 [29-38] weeks, age at the time of surgery was median 2 [2-14] days, average(±SD) body weight was 2515±950 grams. The duration of anesthesia was 146±57 minutes. 50% of the procedures were abdominal, 23% thoracic and 27% were miscallenous. Diuresis was signifinatly lower in the postoperative period (3,6 [2,1-4,9] ml/kg/h before versus 2,5 [1,3-3,6] ml/kg/h after (p=0,022)). There was no significant difference between the pre- and postoperative average and minimum MAP values. Regarding blood gas parameters, we found significantly lower bicarbonate (-1,3 mmol/l, p= 0,49) and base excess (-1,7 mmol/l, p=0,014) levels in the postoperative period.

Conclusion

We found lower diuresis, bicarbonate and base excess levels postoperatively. Further data collection and analysis is needed to determine clinical relevance of this observation.

Funding

Hungarian Scientific Research Fund grants 135222, SE250+ grant