The effect of centralized care on the management of postoperative fluctuations in plasma sodium concentration after pediatric suprasellar brain tumor surgery
An erratum to this article was published (Pituitary, 23 Aug 2026 ↗)
Authors' conclusion
Trends observed after centralization of care for children with (supra)sellar tumors may suggest improved postoperative AVP-D management, resulting in less frequent and less severe fluctuations in plasma sodium concentrations.
Study context
- Population
- Children who underwent neurosurgery for a (supra)sellar tumor at the Princess Máxima Centrum (Utrecht, the Netherlands), January 2018–December 2023; median age 7.9 years (range 0–17.5)
- Participants
- 73 children
- Exposure
- Post-centralization care in context of pre-centralization data
- Outcome
- Postoperative sodium fluctuations ≥ 10 mmol/L/24 h in patients with early postoperative AVP-D
- Follow-up
- First 10 postoperative days
Methodological detailssingle-centre, comparison with pre-centralization data
- Single-centre
- Comparison with pre-centralization data
Main finding
As reported in the abstract
Sodium fluctuations ≥ 10 mmol/L/24 h among patients with postoperative AVP-D
- Postoperative arginine vasopressin-deficiency (AVP-D)
- 69.7%
- Sodium fluctuations ≥ 10 mmol/L/24 h in AVP-D patients
- 49.1%
- Maximum delta plasma sodium
- 30 mmol/L/24 h
- Previous Dutch (pre-centralization) study: sodium shifts ≥ 10 mmol/L/24 h with early postoperative AVP-D
- 75.3%
- Previous Dutch study: maximum delta
- 46 mmol/L/24 h
Observational data: associations, not effects.
Further findings
Trend in sodium fluctuations since 2018 · 2023
- Sodium fluctuations diminished; maximum delta plasma sodium in 2023
- 14 mmol/L/24 h
Neurological symptoms
- No association between early postoperative AVP-D and neurological symptoms
Original publication
The effect of centralized care on the management of postoperative fluctuations in plasma sodium concentration after pediatric suprasellar brain tumor surgery. Pituitary. Published 29 March 2026. doi:10.
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