Postoperative Outcomes For Pediatric Patients With Neonatal Necrotizing Enterocolitis Undergone Laparotomy Based On Crystalloid Administration

Objective: To evaluate the relationship between intraoperative crystalloid administration and postoperative outcomes in pediatric patients with NEC undergone laparotomy.Methods: 172 patients with NEC undergoing surgery from January 2012 to September 2018 in Children’s Hospital of Chongqing Medical University were evaluated based on the median amount of corrected crystalloid fluids as low group(<25.89mL/kg*h)versus high group(>25.89mL/kg*h),First time to enteral feeds,first defecation,the incidence of complications,the postoperative length of NICU or ICU stay,intestinal failure and postoperative death were detected and compared.Results: Postoperative mortality of 172 patients with NEC was 14%,and panintestinal involvement(OR=9.035,95%CI=3.0431~26.828,P= 0.000)was an independent risk factor for postoperative death.Univariate analysis showed that the incidence of postoperative complications between the two groups was statistically significant(P<0.05).The postoperative univariate analysis p<0.05 with statistically significant variables was included in the logistic backward stepwise regression analysis,we can find: intraoperative crystalloid administration(OR=0.955,95%CI=0.914~0.997,P=0.036)is the occurrence of postoperative complications protective factor.Conclusion: The mortality of patients with NEC is most affected by panintestinal involvement,which has no relation to intraoperative crystalloid administration.Panintestinal involvement and intraoperative hypotension can increase intraoperative crystalloid administration,while intraoperative colloid can reduce it,and all of them can affect postoperative prognosis.In this study,postoperative complications could be reduced when intraoperative crystalloid administration was more than 25.89ml/kg/h.And the more crystalloid administration was,the lower risk of postoperative complications.