PMID: 8938360Feb 1, 1996Paper

End-tidal carbon dioxide for monitoring primary closure of gastroschisis

Journal of Pediatric Surgery
N K PuffinbargerW P Tunell

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.

Citations

Aug 19, 2007·Pediatric Surgery International·J AlloteyS Patel
Jun 11, 2003·Annals of Surgery·Joseph N KiddCharles W Wagner
May 8, 2007·Journal of Perinatal Medicine·Norberto Hernández SiverioJuan Mario Troyano Luque
Nov 21, 2008·Seminars in Pediatric Surgery·Sean Marven, Anthony Owen
Mar 10, 2015·Plastic and Reconstructive Surgery. Global Open·Wenceslao M CalongeAntónio Ochoa de Castro
May 8, 2000·Indian Journal of Pediatrics·S Dutta

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