End-tidal carbon dioxide for monitoring primary closure of gastroschisis.

Abstract:

:Previous criteria for primary reduction of the herniated viscera in newborn infants with gastroschisis included intraoperative respiratory rate, cardiac indices, degree of viscero-abdominal disproportion, size of defect, and lower extremity turgor. From 1976 through 1993, 129 neonates with gastroschisis were treated at Children's Hospital of Oklahoma. Intraoperative end-tidal carbon dioxide (ETCO2) monitoring was standard therapy beginning in 1985. The authors evaluated the effect of abdominal closure on ETCO2 to determine if there was a particular ETCO2 level at which closure was not feasible. There was no difference in overall mortality, birth weight, or postoperative ventilation requirements between children who had closure before 1985 (ie, without ETCO2 monitoring) and those who had repair after 1985. However, more cases in the 1985-1993 group had primary closure, and none of these required conversion to a staged procedure. An ETCO2 of > or = 50 suggests that primary closure may be unsafe. These data suggest that infants with gastroschisis can have primary closure based on intraoperative ETCO2 monitoring; no additional invasive monitoring would be necessary to assess closure.

journal_name

J Pediatr Surg

authors

Puffinbarger NK,Taylor DV,Tuggle DW,Tunell WP

doi

10.1016/s0022-3468(96)90016-0

subject

Has Abstract

pub_date

1996-02-01 00:00:00

pages

280-2

issue

2

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(96)90016-0

journal_volume

31

pub_type

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