The Association Between Platelet Mass Index and Mechanical Ventilation in Pediatric Surgery Cases

Abstract

Platelet mass index (PMI) is an indicator of platelet functionality. This study aimed to examine the relationship between PMI and mechanical ventilation need in infants less than 1 year of age who underwent gastrointestinal system surgery. We retrospectively reviewed the medical records of cases that underwent gastrointestinal surgery in the last 10 years (2010-2020) at Baskent University Konya Hospital. Demographic data, indications for surgery, age at surgery, preoperative blood tests, hospitalization times, discharge status, mechanical ventilation need and duration, sepsis, accompanying anomalies, recurrent surgery requirements were collected from patient records. The study group (n: 143) was divided into 2 groups as the need for mechanical ventilation (MV; n: 73) and the group that did not need mechanical ventilation (n-MV; n: 70). Data were analyzed with SPSS version 25. PMI was significantly lower in the MV group (1999 Vs 2798, p< .001). 65% of the cases were newborns. Mean gestational age was 34.5 ±4 weeks, and birth weight was 2100 ± 820 g. Most of the cases that need surgical intervention consist of small bowel atresia, esophageal atresia, surgeries due to necrotizing enterocolitis, and anal atresia. Ileus was present in 54% of the patients. The recurrent surgery requirement was 34%. The frequency of accompanying cardiac anomalies was 30.6%, and the rate of proven sepsis was 38.3%. Preoperative 2163 PMI value can discriminate not needing MV with 72% sensitivity and 69% specificity (AUC: .699, p<.001). When the basic characteristics of the groups were evaluated, 83% of the patients who underwent MV were in the newborn group. The birth weight, gestational age, hospital duration, oxygen exposure, culture-positive sepsis rates, total parenteral nutrition (TPN) rates, and duration were found to be significantly higher in patients who underwent MV. While there was no difference in the number of white blood cells in the preoperative blood analysis, the neutrophil-lymphocyte (N-L) ratio, platelet number, albumin values were significantly lower and CRP values were significantly higher in the MV group. There was no difference in the platelet –lymphocyte (PL) ratio. High PMI values can be used as a parameter to discriminate the need for mechanical ventilation