Pyloric stenosis--postoperative care on a nonsurgical ward.
J Surg Res
; 199(1): 149-52, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-25972312
ABSTRACT
BACKGROUND:
Recent progress has been made in the care of infants with hypertrophic pyloric stenosis (HPS), including earlier operative intervention and shorter hospital length of stay (LOS), which is attributable to expedited postoperative feeding protocols developed and implemented by surgeons. We hypothesized that patients with HPS admitted to a unit that is co-managed by nonsurgeon providers postoperatively have a longer LOS than those on the surgical ward. MATERIALS ANDMETHODS:
We reviewed the medical records of infants who underwent pyloromyotomy for HPS at a single institution from April, 2009-July, 2013.RESULTS:
A total of 259 patients underwent pyloromyotomy (35 female; 13.5%), 205 (79%) were admitted to the surgical ward; 46 had a planned neonatal intensive care unit (NICU) admission (18%) and were co-managed with the neonatology team. Eight (3%) had an unplanned NICU admission and were excluded from the analysis. The groups did not differ in terms of sex, age, serum electrolytes at presentation, or time between surgeon evaluation and operative intervention. Surgical ward patients had longer preoperative symptom duration. Operative time was longer in the NICU patients. Comparing the two groups, there was no difference in postoperative apnea, hypoxic, or bradycardic episodes. NICU patients achieved ad libitum feeds later than floor patients (2.0 versus 1.4 d; P = 0001) and had a longer postoperative LOS (2.2 versus 1.6 d; P = 0.0012).CONCLUSIONS:
Patients with HPS admitted to the NICU postoperatively had a longer time to full feeds and hospital LOS. The reduction in LOS between hospital wards may be improved with implementation of a hospital-wide postoperative protocol for patients with HPS.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pós-Operatórios
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Centro Cirúrgico Hospitalar
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Unidades de Terapia Intensiva Neonatal
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Estenose Pilórica Hipertrófica
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Tempo de Internação
Tipo de estudo:
Evaluation_studies
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Guideline
Limite:
Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2015
Tipo de documento:
Article