Newborns with esophageal atresia treated at the Pediatric Intensive Care Unit in the period from 2004 to 2020

Autor: Grubiša, Petra
Přispěvatelé: Polić, Branka, Markić, Joško, Lozić, Bernarda, Pogorelić, Zenon
Jazyk: chorvatština
Rok vydání: 2021
Předmět:
Popis: Cilj istraživanja: Cilj ovog istraživanja je analizirati demografske, epidemiološke, antropometrijske i kliničke karakteristike te ishode liječenja novorođenčadi s atrezijom jednjaka liječene u Zavodu za intenzivnu pedijatriju s postintenzivnom skrbi KBC-a Split u razdoblju od 2004. do 2020. godine. Analizirali smo utjecaj rodne mase na nastanak komplikacija i vrijeme provedeno na respiratoru te utjecaj gestacijske dobi na Apgar zbroj u naših ispitanika. Ispitanici i metode: Istraživanje je provedeno na 19 novorođenčadi s atrezijom jednjaka koja su liječena u Zavodu za intenzivnu pedijatriju s postintenzivnom skrbi KBC-a Split u razdoblju od 2004. do 2020. godine. Da bi se dobili opći podatci o svakom ispitaniku, koristila se bolnička medicinska dokumentacija. Rezultati: Od ukupno 19 novorođenčadi s atrezijom jednjaka, 12 (63%) je bilo muškog spola. Iz jednoplodne trudnoće rođeno je 17 (89,5%) ispitanika. Jedini tip atrezije jednjaka prema Vogtovoj klasifikaciji bio je je 3B tip. Od ukupno 19 ispitanika, 18 (94,7%) je preživjelo. Medijan gestacijske dobi je bio 37,5 tjedna (raspon od 33 - 42). Medijan rodne mase bio je 2500g (raspon od 1710 - 4000). Medijan rodne duljine bio je 49 cm (raspon od 44 – 52). Medijan za Apgar zbroj je 8 (raspon od 0 – 10). Medijan dana provedenih u Zavodu bio je 17 (raspon od 1-115), a medijan dana provedenih na respiratoru bio je 10 (raspon od 1 - 50). Komplikacija je razvilo 15 (79%) ispitanika od kojih su najčešće bile pneumonija i sepsa. Kardiovaskularne anomalije su najčešća kongenitalna popratna malformacija i čine 76% svih pridruženih anomalija, VACTREL asocijaciju je imao 1 ispitanik (5,3%), a neki od sindroma je imalo 4 (21%) ispitanika. Od pridruženih dijagnoza najčešća je bila anemija koju je imalo 6 (31,5%) i hiperbilirubinemija koju je imalo 5 (26,3%) ispitanika. Zaključci: Pravovremeno prepoznavanje ove anomalije je od bitne važnosti za poboljšanje preživljenja. Poboljšanje preživljenja je multifaktorno i može pripisati napretku u neonatalnoj intenzivnoj terapiji, neonatalnoj anesteziji, ventilacijskoj i prehrambenoj podršci, antibioticima, ranim kirurškim intervencijama, kirurškim materijalima i tehnikama. U našem istraživanju u djece s atrezijom jednjaka uočili smo značajan utjecaj gestacijske dobi na Apgar zbroj i rodne mase na broj dana provedenih na respiratoru te na nastanak komplikacija.
Objectives: The aim of this study is to analyze the demographic, epidemiological, anthropometric and clinical characteristics and outcomes of treatment of newborns with esophageal atresia treated at the Department of Intensive Pediatrics with post-intensive care of Univerity Hospital of Split in the period from 2004 to 2020. We analyzed the influence of birth weight on the occurrence of complications and the time spent on the respirator and the influence of gestational age on the Apgar sum in our subjects. Materials and methods: The study was conducted on 19 newborns with esophageal atresia who were treated at the PICU, University Hospital of Split in the period from 2004 to 2020. Hospital medical records were used to obtain general information about each subject. Results: Out of a total of 19 neonates with esophageal atresia, 12 (63%) were male. From singleton pregnancy 17 (89.5%) subjects were born. The only type of esophageal atresia according to Vogt's classification was type 3B. Out of a total of 19 respondents, 18 (94.7%) survived. The median gestational age was 37.5 weeks (range 33 - 42). The median birth weight was 2500g (range 1710 g – 4000 g). The median length of birth was 49 cm (range 44 cm - 52 cm). The median for Apgar score is 8 (range 0 - 10). The median of the days spent in the PICU was 17 (range 1 - 115) and the median days spent on a respirator was 10 (range 1 - 50). Complications developed 15 (79%) subjects, the most common of which were pneumonia and sepsis. Cardiovascular anomalies were the most common congenital concomitant malformation and account for 76% of all associated anomalies, 1 subject had a VACTREL association (5.3%), and 4 (21%) subjects had some of the syndromes. Of the associated diagnoses, the most common were anemia in 6 (31.5%) and hyperbilirubinemia in 5 (26.3%) subjects. Conclusion: Timely recognition of this anomaly is essential to improve survival. Improving survival is multifactorial and can be attributed to advances in neonatal intensive care, neonatal anesthesia, ventilation and nutritional support, antibiotics, early surgical interventions, surgical materials and techniques. In our study, in neonates with esophageal atresia, we observed a significant effect of gestational age on Apgar score and birth weight on the number of days spent on a respirator as well as the occurrence of complications.
Databáze: OpenAIRE
Externí odkaz: