Postoperative noninvasive ventilation and complications in esophageal atresia-tracheoesophageal fistula

Journal of Pediatric Surgery
Amaryllis FerrandAnn Aspirot

Abstract

This study examines the impact of postoperative noninvasive ventilation strategies on outcomes in esophageal atresia-tracheoesophageal fistula (EA-TEF) patients. 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 (p ≤ .05). 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 (P = .005). Use of HFNC was associated with anastomotic leak (P = .009) and mediastinitis (P = .036). These data suggest that postoperative noninvasive ventilation techniques are associated with a significantly higher risk of anastomotic leak and mediastinitis. Further prospective research is...Continue Reading

Citations

Jul 28, 2020·Pediatric Pulmonology·Anastassios C KoumbourlisThomas Kovesi
Sep 10, 2020·BMJ Case Reports·Anna Swenson SchalkwykBalazs Horvath
Apr 25, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Giovanni LandoniLuca Cabrini
Aug 5, 2021·Journal of Pediatric Surgery·Olugbenga Michael AworantiDavid C G Crabbe
Dec 9, 2021·Paediatric Anaesthesia·Luis Sequera-RamosAlexander Fuchs

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