Analysis of pulmonary infection and related factors after craniotomy of brain stem tumor resection in children

Objective To analyze the incidence and related factor of pulmonary infection in child patients (0-16 years) after brainstem tumor resection. Methods A retrospective analysis was conducted on 103 patients who admitted into department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University and underwent brainstem tumor resection from January 2016 to June 2018. The preoperative, intraoperative and postoperative data were collected to explore the incidence of postoperative pulmonary complications and the effects of related factors on pulmonary infection, and establish a regression model. Results A total of 103 patients were enrolled in this study. There were 46 cases of pulmonary infection (44.7%), with respiratory failure in 16 cases (34.8%) and atelectasis in 4 cases(8.7%). The variables associated with postoperative pneumonia included output volume per kilogram, urine volume per kilogram, operation time, medulla oblongata tumor, serum albumin 1 d after surgery and postoperative application of ventilators. According to multi-variate Logistic regression analysis, the independent risk factors for pulmonary infection in children after brainstem tumor resection were as follows: operation time [odds ratio(OR)=1.008, 95% confidence interval(CI) 1.001-1.015], medulla oblongata tumor(OR=3.312, 95%CI 1.096-8.947), and postoperative application of ventilators(OR=8.042, 95%CI 1.485-43.545). Conclusions The incidence of pulmonary infection is reaching 44.7% in child patients undergoing brainstem tumor resection. Increasing attention should be paid on perioperative management. Operation time, medulla oblongata tumor, and postoperative application of ventilators are the independent risk factors that result in an increased incidence of pulmonary infections after brainstem surgery. Key words: Children; Brain stem; Tumor; Pulmonary infection