Predictors of outcomes in infants with gastroschisis treated with a preformed silo.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-12-05 DOI:10.1007/s00383-024-05922-7

Rebecca Lee, Theodore Dassios, Niyi Ade-Ajayi, Mark Davenport, Ann Hickey, Anne Greenough

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引用次数: 0

Abstract

Purpose: To describe the outcomes of infants with gastroschisis treated with a preformed silo (PFS) and determine whether routinely measured early physiological parameters, sepsis (blood culture positive), gastroschisis complexity or location of birth influenced the length of stay (LOS) and duration of parenteral nutrition (PN).

Methods: Infants cared for in a tertiary surgical neonatal intensive care unit during a 10-year period were identified.

Results: Seventy-seven infants were assessed [median gestational age 36 + 6 (IQR 35 + 3 to 38 + 0)] weeks. All survived; 82% were inborn. The median LOS was 37 (IQR 28-76.5) days and duration of PN was 28 (IQR 21-53) days. In the first 72 h, the worst median lactate, base excess and 'toe-core' gap were 4.2 (IQR 3.0-5.8) mmol/l, -7.0 (IQR - 5.55 to - 9.35), 3.4 (IQR 3.0-4.2) °C respectively. There were no significant correlations between early physiological parameters or place of birth and LOS or PN days, but sepsis (n = 18 infants) and complex gastroschisis (n = 13 infants) were associated with an increased LOS and PN duration (both p < 0.001).

Conclusions: Survival was 100% in infants with gastroschisis who were managed with PFS, sepsis and gastroschisis complexity were associated with a longer hospital stay and duration of parenteral nutrition. Level of Evidence (I-V): IV.

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预成型筒仓治疗婴儿胃裂结局的预测因素。

目的：描述预成型筒仓（PFS）治疗胃裂婴儿的结果，并确定常规测量的早期生理参数、败血症（血培养阳性）、胃裂复杂性或出生地点是否影响住院时间（LOS）和肠外营养（PN）的持续时间。方法：在三级外科新生儿重症监护病房照顾的婴儿在10年期间确定。结果：77例婴儿被评估[中位胎龄36 + 6 (IQR 35 + 3至38 + 0)]周。所有幸存下来;82%是天生的。中位LOS为37 （IQR 28-76.5）天，PN持续时间为28 （IQR 21-53）天。在前72 h，最差的乳酸中位数、碱过量和“趾核”间隙分别为4.2 (IQR 3.0-5.8) mmol/l、-7.0 （IQR - 5.55 - - 9.35）、3.4 （IQR 3.0-4.2）°C。早期生理参数或出生地点与LOS或PN天数之间没有显著相关性，但败血症（n = 18名婴儿）和复杂性胃裂（n = 13名婴儿）与LOS和PN持续时间增加相关（均p结论：采用PFS治疗的胃裂婴儿存活率为100%，败血症和胃裂复杂性与更长的住院时间和肠外营养持续时间相关）。证据等级（I-V）： IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor