Challenges and strategies in ICU nursing for pediatric patients post-craniopharyngioma surgery: a narrative review.

BACKGROUND AND

OBJECTIVE

Craniopharyngioma, a rare brain tumor in children, is primarily managed through surgical resection, but it carries a high risk of postoperative complications. These patients often require intensive care unit (ICU) monitoring and specialized nursing interventions. This narrative review aims to synthesize evidence on ICU nursing strategies for pediatric patients after craniopharyngioma surgery, focusing on monitoring, complication management, pain control, nutritional and psychological support, and multidisciplinary collaboration.

METHODS

We conducted a narrative review of literature published from 2010 to 2024 using PubMed. Keywords included "children", "craniopharyngioma", "intensive care unit", "postoperative care", and "nursing challenges". Studies were selected based on predefined inclusion and exclusion criteria. Ethical approval was not required.

KEY CONTENT AND FINDINGS: Analysis of included studies (total sample >1,200 pediatric cases across 12 studies) showed that visual function improvement was reported in up to 91% (range, 85-95%, n=342) of patients receiving structured postoperative monitoring. Diabetes insipidus (DI) occurred in approximately 36% (range, 30-45%, n=450) of cases, highlighting the need for vigilant electrolyte surveillance. Effective nursing interventions included early neurological assessment, strict input-output monitoring, multimodal pain management, enteral nutrition (EN) support, and family-centered psychological care. Multidisciplinary collaboration was consistently associated with reduced ICU length of stay and improved parent satisfaction.

CONCLUSIONS

This review underscores the importance of individualized, evidence-based ICU nursing care in improving postoperative outcomes for pediatric craniopharyngioma patients. Despite observed benefits, large-scale randomized controlled trials (RCTs) are still needed to validate specific nursing protocols.