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

Autores

  • Ana Carolina Redondo Médica Pediatra, Neonatologista e Mestre em Ciências pela Faculdade de Medicina da Universidade de São Paulo (FMUSP) – São Paulo
  • Rubens Feferbaum Professor Livre Docente em Neonatologia pela FMUSP, Médico Assistente do CTIN2 do Instituto da Criança do HCFMUSP – São Paulo
  • Renata Amato Vieira Professor Livre Docente em Neonatologia pela FMUSP, Médico Assistente do CTIN2 do Instituto da Criança do HCFMUSP – São Paulo
  • Daniel de Albuquerque Rangel Moreira
  • Uenis Tannuri
  • Werther Brunow de Carvalho
  • Maria Esther Jurfest Rivero Ceccon

DOI:

https://doi.org/10.7322/jhgd.119266

Palavras-chave:

gastroschisis, new-born, mortality, total parenteral nutrition, renal insuffi ciency, infection.

Resumo

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.

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Publicado

2016-08-29

Edição

v. 26 n. 2 (2016)

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Artigos Originais

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