Anesthetic evaluation of affecting factors the need for postoperative intensive care unit in pediatric patients undergoing Nissen fundoplication surgery: a retrospective study

Our aim in this study is to investigate the factors that increase the postoperative intensive care needs of pediatric patients who undergo Nissen Fundoplication (NF) surgery. Between January 2018 and January 2023, 98 cases under the age of 18 who had NF were included in our study. The patients' age, gender, body weight, preoperative BUN, albumin values, as well as surgery type, accompanying neurological disease, cardiac disease, recurrent lung infection and preoperative antibiotic use were obtained. While the total intensive care unit admission rate was 33,7%, the intubated discharge rate was 11,2% and the rate of postoperative respiratory failure was 5,1%. It was observed that the decrease in albumin level was a risk factor independent of other factors in predicting the need for intensive care after surgery. As the albumin level increased, the need for intensive care unit after surgery decreased statistically significantly (OR=0,186; %95 CI: 0,061-0,564 p=0,003). Although it did not show a statistically significant relationship, the incidence of neurological disease, recurrent lung infection, and the coexistence of both neurological disorder and recurrent lung infection were found to be higher in the postoperative intensive care unit group (p=0,095; p=0,115 and p=0,102). Similarly, although the frequency of antibiotic use due to preoperative pneumonia was higher in the postoperative intensive care unit group, the difference was not statistically significant (p=0,272). As a result, it has been shown that preoperative albumin level may be a significant risk factor in determining the need for postoperative intensive care in pediatric patients undergoing NF surgery, and that accompanying recurrent lung infection or neurological disease may also be important factors in determining the need for postoperative intensive care. Keywords: Nissen Fundoplication, postoperative intensive care unit, pediatric intensive care unit