Gastroschisis and late-onset neonatal sepsis in a tertiary referral center in Southeastern Brazil

Bigio, Juliana Zoboli Del; Tannuri, Ana Cristina Aoun; Falcão, Mário Cícero; Carvalho, Werther Brunow de; Matsushita, Felipe Yu

doi:10.1016/j.jped.2021.05.003

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Animais recém-nascidos com gastrosquise são um desafio para os clínicos e a padronização dos cuidados para os animais com esse tipo de anomalia permite a evolução da prática, assim como, a melhoria dos resultados dos procedimentos cirúrgicos e uma boa relação custo-benefício, apoiando uma cultura organizacional dedicada à constante melhoria (BIGIO et al, 2022).…”

Section: Resultsunclassified

Gastrosquise em filhote canino sem raça definida – relato de caso

Silva¹,

Souza²,

Caciano³

et al. 2023

Rev Agr Acad

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In canine neonates, birth defects are commonly encountered in routine veterinary practice. Among them is gastroschisis, which consists of a failure to close the abdominal wall during the fetal period, triggering the exit of abdominal organs and, sometimes, also organs of the thoracic cavity. Animals affected with this anomaly may have limited treatment. In order to guarantee a good prognosis for carrier patients, as in the case presented, the surgical procedure of gastroschisis was successfully performed. The present work aims to present a case report of a canine patient diagnosed with gastroschisis, where a surgical procedure was performed to replace the intestine and close the animal's abdominal cavity. The anesthetic procedure and surgical correction were effective in correcting the malformation.

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Section: Resultsunclassified

Gastrosquise em filhote canino sem raça definida – relato de caso

Silva¹,

Souza²,

Caciano³

et al. 2023

Rev Agr Acad

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“…Overall rates of infections are two to three times higher for patients in a NICU than in other hospital units, and rates of ventilator-associated pneumonia and primary bacteremia—most cases of which originate from intravascular devices—are 10 times higher [ 21 ]. In addition, newborns with AWD are subject to an increased risk of NI and late-onset sepsis because of their underlying disease; because they require surgical interventions, and because sometimes prosthetic materials are needed to close the abdominal defect, they have a prolonged period of antibiotic therapy and parenteral nutrition through a central venous catheter, while intra-abdominal pressure and diuresis are monitored with the help of urinary catheters for a long period of time [ 7 , 23 , 25 , 26 ]. Risk factor analysis identifies the circumstances that put a patient at increased risk for NI and leads to the development of adequate preventive strategies.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Infections Affecting Newborns with Abdominal Wall Defects

et al. 2023

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Abdominal wall defects are serious birth defects, with long periods of hospitalization and significant costs to the medical system. Nosocomial infection (NI) may be an additional risk factor that aggravates the evolution of newborns with such malformations. Methods: in order to analyze the factors that may lead to the occurrence of NI, we performed a retrospective study over a period of thirty-two years (1990–2021), in a tertiary children’s hospital; 302 neonates with omphalocele and gastroschisis were eligible for the study. Results: a total of 33.7 % patients were infected with one or more of species of bacteria or fungi. These species were Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp., Staphylococcus spp., Enterococcus spp. or Candida spp., but the rate of NI showed a significant decrease between the 1990–2010 and 2011–2021 period (p = 0.04). The increase in the number of surgeries was associated with the increase in the number of NI both for omphalocele and gastroschisis; in the case of gastroschisis, the age of over 6 h at the time of surgery increased the risk of infection (p = 0.052, marginal statistical significance). Additionally, for gastroschisis, the risk of NI was 4.56 times higher in the presence of anemia (p < 0.01) and 2.17 times higher for the patients developing acute renal failure (p = 0.02), and a hospitalization period longer than 14 days was found to increase the risk of NI 3.46-fold (p < 0.01); more than 4 days of TPN was found to increase the NI risk 2.37-fold (p = 0.015). Using a logistic regression model for patients with omphalocele, we found an increased risk of NI for those in blood group 0 (OR = 3.8, p = 0.02), in patients with a length of hospitalization (LH) of ≥14 days (OR = 6.7, p < 0.01) and in the presence of anemia (OR = 2.5, p = 0.04); all three independent variables in our model contributed 38.7% to the risk of NI. Conclusion: although in the past 32 years we have seen transformational improvements in the outcome of abdominal wall defects, there are still many factors that require special attention for corrections.

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“…[67][68][69][70] Gestational age is of paramount importance to neurodevelopmental outcomes, and as 30 to 50% of children with GS are born prematurely, risk for neurodevelopmental delay is substantial. 1,[71][72][73][74][75] Due to the nature of the disease, GS patients all require at least one operation with a subset requiring multiple operations. This results in exposure to sedatives, narcotics, and general anesthesia, which has been shown to increase the risk of adverse neurodevelopment, especially in those who experience multiple exposures to anesthetics.…”

Section: Limitationsmentioning

confidence: 99%

“…29,30,50,[79][80][81][82] Risk of sepsis is increased in cases of complex GS (i.e., intestinal atresia, necrosis, perforation, or volvulus). 75,83 These confounds likely impact neurodevelopmental outcomes in children with GS, making it difficult to determine the specific contributions of those variables or GS itself to neurodevelopmental prognosis.…”

Section: Limitationsmentioning

confidence: 99%

Long-Term Neurodevelopmental Outcomes in Children with Gastroschisis: A Review of the Literature

Rundell,

Bailey,

Wagner

et al. 2024

Am J Perinatol

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This study aimed to investigate and present a review of the literature on long-term neurodevelopmental outcomes in children with gastroschisis. Gastroschisis is the most common abdominal wall defect. Children with gastroschisis are at high risk for premature birth, intestinal failure, sepsis, and repeated anesthesia exposure, which collectively increase the risk for adverse long-term neurodevelopmental outcomes. The existing literature on neurodevelopmental outcomes is limited in number, quality, and generalizability, creating a gap in clinical knowledge and care. Five internet databases were searched by a professional research librarian: Ovid MEDLINE, Scopus, Web of Science, PsycINFO, and Cochrane Library. Included articles were (1) published in English, (2) included postneonatal hospital discharge neurodevelopmental outcomes of children with gastroschisis, and (3) included patients under the age of 18 years. No date parameters were applied. The paucity of literature on long-term neurodevelopmental outcomes in gastroschisis children has left large gaps in the body of knowledge on post-hospital care of such children. In this review, 37 articles were found evaluating neurodevelopmental outcomes in gastroschisis and, while conclusions were contradictory, the literature broadly indicated the potential for neurodevelopmental deficits in the gastroschisis pediatric population. A significant limitation of this review was the heterogeneous samples included in available literature, which confounded the ability to determine cognitive risk of gastroschisis independent of other abdominal wall defects. Findings of this review demonstrate potential risk for neurodevelopmental deficits in the pediatric gastroschisis population exist, yet additional research is needed to definitively predict the significance, type, onset, and trajectory of neurodevelopmental impairment in this population. The significant gaps in long-term outcomes data have elucidated the need for prospective, longitudinal investigation of various cognitive domains in homogenous gastroschisis populations to properly evaluate prevalence of neurodevelopmental deficits and guide recommendations for long-term clinical care. Key Points

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Gastroschisis and late-onset neonatal sepsis in a tertiary referral center in Southeastern Brazil

Cited by 6 publications

References 25 publications

Gastrosquise em filhote canino sem raça definida – relato de caso

Gastrosquise em filhote canino sem raça definida – relato de caso

Nosocomial Infections Affecting Newborns with Abdominal Wall Defects

Long-Term Neurodevelopmental Outcomes in Children with Gastroschisis: A Review of the Literature

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