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01 October 2003

Congenital gastroschisis – results of treatment in the ICU

Wojciech Walas, Marek Ziębiński, Małgorzata Puziewicz-Krzemienowska, Ryszard Noparlik

Med Sci Monit 2003; 9(5): 17-19 :: ID: 428677

Abstract

Background: The authors present a retrospective review of 11 cases of gastroschisis in neonates treated in the Paediatric Intensive Care Unit (PICU)in Opole in the years 1997 –2003.Material/Methods: All babies were operated on the 1 st day of life,in 3 of them abdominal wall was closed in a one-step operation, in 8 patients the viscera were placed in a plastic pouch sewed into the abdominal wall which was hung on a traction. Results: Median time before coplete surgical closure of the abdominal wall was 13 days,mechanical ventilation was required for median 18,opioids for 16 days,parenteral nutrition for 26 days,and antibiotic therapy for 27 days.No muscle relaxants were applied after the operation The median total time of treatment in the ICU was 29 days.Feeding through a gastric tube was introduced averagely on the 21st day.In 3 patients (28%) there were surgical complications,in 4 (36%) septicaemia developped. One patient with an inborn sepsis died on first day of life. Conclusions: Treatment of congenital gastroschisis with a plastic pouch has satisfying results,complications appear frequently but do not foredoom a bad prognosis.No muscle relaxation is needed in the postoperative period.In spite of relatively long period of mechanical ventilation the median total stay in ICU was only moderately long.

Keywords: newborn infant, Gastroschisis, neonatal postoperative care

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750