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Landisch, Rachel M., MD; Massoumi, Roxanne L., MD; Christensen, Melissa, BS, CCRC; Wagner, Amy J., MD
The Journal of surgical research, 07/2017, Letnik: 215Journal Article
Abstract Background Perioperative hypothermia decreases nutrient and oxygen delivery to tissues and, in adult studies, increases the risk of infectious complications. Gastroschisis (GS) places newborns at risk for hypothermia by nature of exposed viscera and excessive heat loss. Although hypothermia is a known cause of mortality in GS, the rate of infectious complications in this at-risk cohort has not yet been delineated. Materials and Methods A retrospective cohort study was performed at our single tertiary-referral hospital, evaluating patient and operative characteristics of all gastroschisis infants who underwent operative closure. Intraoperative temperatures were recorded, defining hypothermia as mild (35.5-35.9°C), moderate (35.0-35.4 °C), or severe (< 35 °C). Temperature nadirs, procedural and anesthesia duration were observed. The primary outcome was 30-day surgical site infections (SSI). Secondary measures included other infectious complications (ICs). Results Among 43 gastroschisis neonates, 21 (48.8%) had intraoperative hypothermia, classified as mild in 2 (4.7%), moderate in 8 (18.6%) and severe in 11 (25.6%). Nineteen ICs occurred in 35.9% of patients, including 10 (23.3%) SSIs. There was no association between hypothermia and ICs. Patient and operative characteristics were similar between normothermic and hypothermic groups, except that normothermic infants were more likely to have silos placed with delayed closure than hypothermic patients (63.6% vs 23.8%, p = 0.01). Conclusions Infants with gastroschisis are at high risk for hypothermia and infectious complications; though, newborns with silos were less subject to temperature lability. A multi-institutional study with greater power is needed to further investigate the relationship between perioperative hypothermia and surgical infectious complications.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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