Preoperative hyperchloraemia and intraoperative metabolic acidosis in infants undergoing anorectal pull-through for Hirschsprung's disease: A retrospective observational study.

Paediatric literature shows that procedures exceeding 5 h increase postoperative respiratory fatigue and intensive care requirements.[ 10 11 ] Although intraoperative acidosis itself did not significantly correlate with CICU admission ( P = 0.186), the near-significant trend for preoperative bicarbonate ( P = 0.052) suggests depleted physiological reserve may influence postoperative outcomes.[ 12 ] Although mechanical bowel preparation remains debated within enhanced recovery frameworks,[ 8 ] balanced salt solutions should be preferred during bowel preparation.

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Preoperative bicarbonate showed a trend towards significance ( P = 0.052).

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