Lee Rebecca, Dassios Theodore, Ade-Ajayi Niyi, Davenport Mark, Hickey Ann, Greenough Anne
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, 4th floor Golden Jubilee Wing, Denmark Hill, London, SE5 9RS, UK.
Pediatr Surg Int. 2024 Dec 5;41(1):22. doi: 10.1007/s00383-024-05922-7.
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).
Infants cared for in a tertiary surgical neonatal intensive care unit during a 10-year period were identified.
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).
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.
描述采用预制袋（PFS）治疗腹裂婴儿的结局，并确定常规测量的早期生理参数、败血症（血培养阳性）、腹裂复杂性或出生地点是否会影响住院时间（LOS）和肠外营养（PN）持续时间。
确定在一家三级外科新生儿重症监护病房接受治疗的10年间的婴儿。
评估了77例婴儿[中位胎龄36+6（四分位间距35+3至38+0）]周。所有婴儿均存活；82%为足月儿。中位住院时间为37（四分位间距28 - 76.5）天，肠外营养持续时间为28（四分位间距21 - 53）天。在最初72小时内，最差的中位乳酸、碱剩余和“趾-核心”温差分别为4.2（四分位间距3.0 - 5.8）mmol/L、-7.0（四分位间距 - 5.55至 - 9.35）、3.4（四分位间距3.0 - 4.2）°C。早期生理参数或出生地点与住院时间或肠外营养天数之间无显著相关性，但败血症（n = 18例婴儿）和复杂腹裂（n = 13例婴儿）与住院时间延长和肠外营养持续时间增加相关（均p < 0.001）。
采用预制袋治疗的腹裂婴儿存活率为100%，败血症和腹裂复杂性与更长的住院时间和肠外营养持续时间相关。证据级别（I - V）：IV。
