Postoperative noninvasive ventilation and complications in esophageal atresia-tracheoesophageal fistula.
J Pediatr Surg
; 54(5): 945-948, 2019 May.
Article
em En
| MEDLINE
| ID: mdl-30814037
ABSTRACT
PURPOSE:
This study examines the impact of postoperative noninvasive ventilation strategies on outcomes in esophageal atresia-tracheoesophageal fistula (EA-TEF) patients.METHODS:
A single center retrospective chart review was conducted on all neonates followed at the EA-TEF Clinic from 2005 to 2017. Primary outcomes were survival, anastomotic leak, stricture, pneumothorax, and mediastinitis. Statistical significance was determined using Chi-square and logistic regression (pâ¯≤â¯.05).RESULTS:
We reviewed 91 charts. Twenty-five infants (27.5%) were bridged with postextubation noninvasive ventilation (15 on Continuous Positive Airway Pressure (CPAP), 5 on Noninvasive Positive Pressure Ventilation (NIPPV), and 14 on High-Flow Nasal Cannula (HFNC)). Overall, 88 (96.7%) patients survived, 25 (35.7%) had a stricture, 14 (20%) had anastomotic leak, 9 (12.9%) had a pneumothorax, and 4 (5.7%) had mediastinitis. Use of NIPPV was associated with increased risk of mediastinitis (Pâ¯=â¯.005). Use of HFNC was associated with anastomotic leak (Pâ¯=â¯.009) and mediastinitis (Pâ¯=â¯.036).CONCLUSIONS:
These data suggest that postoperative noninvasive ventilation techniques are associated with a significantly higher risk of anastomotic leak and mediastinitis. Further prospective research is needed to guide postoperative ventilation strategies in this population. TYPE OF STUDY Retrospective study. LEVEL OF EVIDENCE IV.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Respiração com Pressão Positiva
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Fístula Traqueoesofágica
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Pressão Positiva Contínua nas Vias Aéreas
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Atresia Esofágica
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Ventilação não Invasiva
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article