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. 2022 Oct 20;13(10):1905.
doi: 10.3390/genes13101905.

Postoperative Hypocalcemia following Non-Cardiac Surgical Procedures in Children with 22q11.2 Deletion Syndrome

Jill M Arganbright  1   2 , Meghan Tracy  1 , Max Feldt  3 , Srivats Narayanan  2 , Ashna Mahadev  2 , Janelle Noel-MacDonnell  2   4
Affiliations

Postoperative Hypocalcemia following Non-Cardiac Surgical Procedures in Children with 22q11.2 Deletion Syndrome

Jill M Arganbright et al. Genes (Basel). .

Abstract

The guidelines for management of children with 22q11.2 deletion syndrome (22q11DS) highlight the risk for developing hypocalcemia after surgery and recommend monitoring calcium perioperatively. Despite this guidance, little has been published on postoperative hypocalcemia and 22q11DS. Our goals were to evaluate the frequency of perioperative calcium monitoring and examine how often postoperative hypocalcemia was identified. This is a retrospective chart review of patients in our 22q Center's repository. Inclusion criteria were a diagnosis of 22q11DS and a history of a non-cardiac surgical procedure. Data collected included all non-cardiac surgeries and perioperative calcium labs. In total, 68 patients were included and underwent 305 on-cardiac surgeries. Patients in only 17% of these surgeries had postoperative calcium testing, but of those tested, 58% showed hypocalcemia. Patients with history of hypocalcemia at the time of chart review undergoing non-cardiac surgeries were tested postoperatively 40% of the time; however, 67% of these had hypocalcemia. Similarly, for patients without history of hypocalcemia, postoperative testing occurred 60% of the time, with 52% of these having hypocalcemia. This study demonstrates that postoperative hypocalcemia in children with 22q11DS following non-cardiac surgeries is common and affects patients both with and without prior history of hypocalcemia. These data support establishing a protocol for perioperative testing/management of hypocalcemia for patients with 22q11DS.

Keywords: 22q deletion syndrome; postoperative hypocalcemia; surgical procedures.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Selection of Study Cohort to obtain homogenous cohort for assessing hypocalcemia.
Figure 2
Figure 2
Serum Calcium Levels Recorded within 48 h of Surgery. For individuals who had >1 serum calcium testing recorded, we looked at trajectories of serum calcium levels and if or when levels returned to normal. (A) Individuals who were observed conservatively and not recommended any postoperative calcium supplementation. (B) Individuals who were recommended some type of postoperative calcium supplementation.
See this image and copyright information in PMC

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