Infectious complications in the management of gastroschisis

Baird, Robert; Puligandla, Pramod; Skarsgard, Erik D.; Laberge, Jean-Martin

doi:10.1007/s00383-011-3038-6

Cited by 40 publications

(29 citation statements)

References 28 publications

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“…Various outcomes have been reported in the literature related to this topic, and the results have been mixed [1,2,7,10,[12][13][14][15]. There are some reports of worse outcomes with early delivery, including an increased risk of infectious complications and poorer long-term neurodevelopmental outcomes [8,12]. Maramreddy found that gastroschisis patients delivered prior to 37 weeks gestation had a 14 times higher risk of morbidities than patients carried to term [2].…”

Section: Discussionmentioning

confidence: 93%

“…Of those studies that have, infections were examined over the first inpatient experience of patients [7,8]. We limited our focus to infectious complications in the first 60 days to eliminate the inclusion of infectious complications that are an effect of prolonged NICU admission so as to include only infections developed secondary to gastroschisis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Identifying strategies to decrease infectious complications of gastroschisis repair

Schlueter¹,

Azarow²,

Hines³

et al. 2015

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Identifying strategies to decrease infectious complications of gastroschisis repair

Schlueter¹,

Azarow²,

Hines³

et al. 2015

Journal of Pediatric Surgery

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“…Notably, we report a higher-than-expected incidence of SSI in infants with gastroschisis compared to other neonates admitted to the NICU. A recent report from the Canadian Pediatric Surgery Network: CAPSNet, reported a 8.2 % rate of SSI in infants with gastroschisis who underwent immediate closure (less than 6 hour after birth) versus a 21 % rate in infants in the delayed (>24 hour after birth) closure group [24]. However, due to the focus of this latter study on infants with gastroschisis, authors were unable to conclude whether this rate of SSI was high compared to a neonatal population.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections in infants admitted to the neonatal intensive care unit

Segal¹,

Kang

Albersheim

et al. 2014

Journal of Pediatric Surgery

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“…A study by Baird et al 28 showed surgical wound infection in 12.6% of cases and infection associated with CVC in 14.9%, particularly with coagulasenegative staphylococci. Still, the authors demonstrated the importance of early closure of the abdominal wall and infectious complications.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the clinical development of a newborn with gastroschisis in an intensive care unit in latin america

Redondo¹,

Feferbaum

Vieira

et al. 2016

J. Hum. Growth Dev.

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Introduction: Congenital malformations are major diseases observed at birth. They are the second most common cause of death in the neonatal population, the fi rst one being prematurity.Objective: To characterise the clinical outcome of newborns with gastroschisis (GS) in a neonatal intensive care unit. Methods:A retrospective observational clinical study in 50 infants with GS using the association of intestinal abnormalities, impossibility of primary closure of the abdominal defect and reoperation necessity as classifi cation criteria for the disease. The signifi cance level was p < 0.05. Results:The hospitalisation to primary surgery occurred with a median age of 2 hours. Fourteen percent of children were subjected to a primary silo interposition and 24% had associated intestinal malformation. Nineteen newborns (NB) required more than one surgery. The median length of stay was 33 days, higher in patients with complex GS (56 days). All NB recovered from urine output 48 hours after surgery and 40% had hyponatraemia and oligoanuria in this period. There was no difference between the natraemia and fasting time (p = 0.79). Weight gain was similar in both groups with total parenteral nutrition and became signifi cantly higher in patients with simple GS after enteral feeding (p = 0.0046). These NB evolved 2.4 times less cholestasis. Late-onset sepsis occurred in 58% of patients and was related to the infection of the central venous catheter in 37.9% of cases. Mortality was higher in infants infected with complex GS and the overall mortality rate was 14%. Conclusion:Clinical characterisation of newborns with gastroschisis depends on the complexity and the knowledge and conduct of morbidities to reduce mortality.Key words: gastroschisis, new-born, mortality, total parenteral nutrition, renal insuffi ciency, infection. INTRODUCTIONCongenital malformations are major diseases observed at birth. In the United States, a prevalence of about 3% 1 is cited. In Brazil, a study at the Fernandez Figueira Institute in Rio de Janeiro found that the prevalence was similar, i.e. 2.7% among live newborns (NB) and 6.7% among stillbirths. Among the causes of death, neonatal malformations are the second most common reason, the fi rst one being prematurity 2 .Gastroschisis (GS) is a congenital malformation of the abdominal wall that has increased in prevalence worldwide; its causes have not been fully elucidated 3 . In the 1960s, the prevalence of this disease was 1:50,000 live births. However, Kirby et al. 4 - -Characteristics of the clinical development of a newborn with gastroschisis in an intensive care unit in latin america J Hum Growth Dev. 2016; 26(2): 190-198 DOI: http://dx.doi.org/10.7322/jhgd.119266 temporal increase of 2.23 per 10,000 live births to 4.42 per 10,000 Regarding the defi nition of live births. The current prevalence in South America is 2.9:10,000 5 . This disease is characterised by a defect in abdominal wall closure with herniation of the intestines and other abdominal organs into the amniotic cavity. ...

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Infectious complications in the management of gastroschisis

Abstract: Infectious complications remain an important consideration in the management of gastroschisis. GPS correlates with the development of infectious complications. Prophylaxis for skin flora and early closure, when feasible, may reduce WI rates.

Cited by 40 publications

References 28 publications

Identifying strategies to decrease infectious complications of gastroschisis repair

Identifying strategies to decrease infectious complications of gastroschisis repair

Surgical site infections in infants admitted to the neonatal intensive care unit

Characteristics of the clinical development of a newborn with gastroschisis in an intensive care unit in latin america

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