Prospective assessment of surgical stress response in patients with craniosynostosis: comparison of clinical and laboratory data

Bashiryan BA, Gadzhieva OA, Satanin LA, et al. . Prospective assessment of surgical stress response in patients with craniosynostosis: comparison of clinical and laboratory data. Burdenko's Journal of Neurosurgery. 2024;88(4):62‑70. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248804162

Подписка 2025 (Burdenko's Journal of Neurosurgery)

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BACKGROUND

Highly traumatic surgical correction of craniosynostosis (CS) is usually followed by severe postoperative period and high risk of complications. Surgical stress response (SSR) is an important and often neglected cause of severe early postoperative period.

OBJECTIVE

To compare clinical and laboratory parameters of SSR in children who underwent various surgeries for CS.

MATERIAL AND METHODS

The study included 63 patients aged 7.02±4.12 months. All ones underwent surgery for CS between October 2021 and June 2022. We analyzed clinical and laboratory markers of SSR, as well as correlation with severity of surgical stress.

RESULTS

No surgical complications were observed. There were postoperative complications in 12 (19.0%) cases including febrile fever in 9 (14.3%) patients, severe pain and edematous syndromes with prolonged hospital-stay in 3 (4.8%) cases. Significant correlations were revealed between severity of surgical stress and certain laboratory markers (CRP, ACTH, T3, insulin, HOMA-IR). The last ones characterized SSR severity. Patients with high scores of stress response demonstrated more severe course of early postoperative period.

CONCLUSION

Surgical stress scale makes it possible to predict early postoperative period and optimize patient management. Lower severity of surgical stress response following endoscopic interventions is another reason for the wider use of low-traumatic surgical methods in pediatric neurosurgery.

Keywords:

craniosynostosis

reconstructive surgery

surgical stress response

inflammatory markers

C-reactive protein

hormonal status

metabolic disorders

stress response modulation

Authors:

Bashiryan B.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-5559-2678

Gadzhieva O.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-9850-050X

Satanin L.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-2051-1855

Mazerkina N.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-0428-0498

Khukhlaeva E.A.

Burdenko Neurosurgical Center

ORCID: 0000-0002-7961-4245

Lavrenyuk E.A.

Burdenko Neurosurgical Center

ORCID: 0009-0004-8477-9564

Tere V.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-4247-8953

Kwan O.K.

Burdenko Neurosurgical Center

ORCID: 0000-0002-6147-7887

Roginsky V.V.

Burdenko Neurosurgical Center

ORCID: 0000-0003-0549-855X

Received:

21.02.2024

Accepted:

31.05.2024

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