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Peer-reviewed veterinary case report

Severe hyperthermia, hypernatremia, and early postoperative death after transethmoidal cavitron ultrasonic surgical aspirator (CUSA)-assisted diencephalic mass removal in 4 dogs and 2 cats.

Journal:
Veterinary surgery : VS
Year:
2014
Authors:
Marino, Dominic J et al.
Affiliation:
Department of Surgery · United States

Plain-English summary

In a study involving four dogs and two cats that underwent a specific type of brain surgery to remove tumors, researchers found serious complications that occurred shortly after the procedure. Many of the animals developed a high fever and elevated sodium levels in their blood, which can be dangerous. The fever typically started about 3.5 hours after the animals were taken off anesthesia, and the average time of death after these complications was around 10.5 hours. Due to these severe outcomes, the researchers concluded that this surgical method should not be recommended.

Abstract

OBJECTIVE: To report clinical findings including severe hyperthermia and hypernatremia after transethmoidal Cavitron ultrasonic surgical aspirator (CUSA)-assisted diencephalic mass removal. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 4) and 2 cats. METHODS: Medical records (1997-2003) of dogs and cats that had transethmoidal CUSA-assisted diencephalic mass removal were reviewed. Retrieved data were: history, signalment, blood work, neurologic examination findings, MRI results, histopathology, postoperative complications, pre- and postoperative medical therapy, and outcome. RESULTS: Tumor types included: meningioma (n = 3), choroid plexus papilloma (1), astrocytoma (1), and pituitary macroadenoma (1). Median onset of hyperthermia was 3.5 hours (range: 1-6 hours) after extubation; median high temperature at onset was 40.3°C, (range: 39.6-41.7°C). Median onset of hypernatremia (median, 172 mmol/L; range: 168-196 mmol/L) was 4.5 hours (range: 1-9 hours) after extubation. Median time of death after hyperthermia was 10.5 hours (range: 6-13 hours) and after extubation was 13.5 hours (range: 11-15 hours). CONCLUSIONS: Transethmoidal CUSA-assisted diencephalic mass removal is associated with early postoperative hyperthermia, hypernatremia, and death, and cannot be recommended.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/25040184/