Direct hyperbilirubinemia in newborns with gastroschisis.
Pediatr Surg Int
; 35(3): 293-301, 2019 Mar.
Article
in En
| MEDLINE
| ID: mdl-30415437
ABSTRACT
BACKGROUND:
Patients with gastroschisis and prolonged total (or partial) parenteral nutrition (PN) commonly develop direct hyperbilirubinemia (DH).OBJECTIVE:
To quantify the prevalence and severity of DH in newborns with gastroschisis and characterize the diagnostic work-up for DH in this patient population. DESIGN/METHODS:
Retrospective chart review of patients born with gastroschisis between 2005 and 2015 for the first 6 months of life.RESULTS:
29 patients were identified with gastroschisis. Mean gestational age and birthweight were 36.4 (± 1.8) weeks and 2.5 (± 0.6) kg. 41% were treated with primary reduction versus staged closure. Peak total and direct bilirubin (DB) levels were 10.17 ± 6.21 mg/dL and 5.58 ± 3.94 mg/dL, respectively. 23 patients (79.3%) were diagnosed with DH and 78.2% underwent additional work-up for hyperbilirubinemia consisting of imaging and laboratory studies, none of which revealed a cause for DH other than the presumed PN-associated cholestasis. In all patients, DB began to decline within 1-10 days of initiation of enteral feeds. CONCLUSION(S) DH is common in patients with gastroschisis and is unlikely to be associated with pathology aside from PN. Additional work-up may lead to unnecessary resource utilization. LEVELS OF EVIDENCE Case series with no comparison group, Level IV.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parenteral Nutrition, Total
/
Gastroschisis
/
Hyperbilirubinemia
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2019
Type:
Article
Affiliation country:
United States