Gastroschisis: Ward Reduction Compared With Traditional Reduction Under General Anesthesia

Davies, Mark W., Kimble, Roy M. and Cartwright, David W. (2005) Gastroschisis: Ward Reduction Compared With Traditional Reduction Under General Anesthesia. Journal of Pediatric Surgery, 40 3: 523-527. doi:10.1016/j.jpedsurg.2004.11.030

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Author Davies, Mark W.
Kimble, Roy M.
Cartwright, David W.
Title Gastroschisis: Ward Reduction Compared With Traditional Reduction Under General Anesthesia
Journal name Journal of Pediatric Surgery   Check publisher's open access policy
ISSN 0022-3468
Publication date 2005-03-01
Sub-type Article (original research)
DOI 10.1016/j.jpedsurg.2004.11.030
Open Access Status File (Author Post-print)
Volume 40
Issue 3
Start page 523
End page 527
Total pages 5
Editor Young, D. G.
Tovar, J. A.
Grosfeld, J. L.
Place of publication Philadelphia, U.S.A.
Publisher W.B. Saunders
Language eng
Subject 321029 Surgery
321006 Gastroenterology and Hepatology
C1
730109 Surgical methods and procedures
321019 Paediatrics
Abstract Background/Purpose In gastroschisis it is proposed that gut reduction may be achieved without intubation or general anesthesia (GA) through ward reduction. The authors aimed to determine if ward reduction decreased morbidity and duration of treatment. Methods Infants born from January 1, 1995, to December 31, 2001, with gastroschisis were managed with either reduction under GA in the operating theatre (OT group) - up to September 1999, or ward reduction (when eligible) in the neonatal unit without GA/ventilation (ward reduction [WR] group) - from September 1999. Results Of the 37 infants, 31 were eligible for ward reduction—15 from the OT group, 16 from the WR group. All infants in the OT group had at least 1 episode of ventilation and 1 GA: 62% of infants in the WR group avoided ventilation (P = .0002) and 81% avoided GA (P < .0001). Infants who had ward reduction had significantly shorter durations of ventilation and oxygen therapy. Septicemia occurred in 31% of the WR group and 7% of the OT group (P = .17). Infants who had ward reduction left intensive care 16 days earlier (P = .02) and tended to reach full enteral feeds 8 days sooner (P = .06) and be discharged from hospital 15 days earlier (P = .05). Conclusions Infants who had ward reduction do better in terms of avoiding GA/ventilation, establishing feeds, and going home earlier. A randomized, controlled trial comparing the 2 approaches is feasible, safe, and worthwhile.
Keyword cohort studies
gastroschisis
operative surgical procedures
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Citation: Mark W. Davies, Roy M. Kimble and David W. Cartwright (2005) Gastroschisis: Ward Reduction Compared With Traditional Reduction Under General Anesthesia, Journal of Pediatric Surgery 2005 40 (3): 523-527. doi:10.1016/j.jpedsurg.2004.11.030 Copyright 2005 Elsevier Inc. All rights reserved. Single copies only may be downloaded and printed for a reader's personal use and study.

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2006 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Mon, 26 Jun 2006, 10:00:00 EST