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Archivos de Pediatría del Uruguay

versão impressa ISSN 0004-0584versão On-line ISSN 1688-1249

Resumo

SILVERA, Fernando et al. Implementation of a perinatal bundles measures in newborns with congenital gastroschisis. Arch. Pediatr. Urug. [online]. 2024, vol.95, n.1, e205.  Epub 01-Jun-2024. ISSN 0004-0584.  https://doi.org/10.31134/ap.95.1.5.

Introduction:

congenital gastroschisis is an increasingly demanded pathology, therefore a care protocol was implemented at the Pereira Rossell Pediatric Hospital (CHPR), and it has been carried out by a multidisciplinary team. In this paper, we aim at assessing the morbidity and mortality impact of survival and morbidity of this application.

Materials and Methods:

comparative before and after study of a historical cohort (GH, n=29) versus a post-protocol application cohort (GP, n=18), in patients with a gestational age ≥36 weeks and birth weight ≥2500 grams assisted in CHPR between 2016-2021.

Results:

no perinatal differences were observed between both groups or in the incidence of complicated GQ. In the GP, a higher incidence of early abdominal closure was decreased (GH 3.4% vs GP 67%, p<0.01), less need to perform a surgical silo (GH 100% vs GP 33%, p<0.01 ), shorter mechanical ventilation administration time (GH 2 days vs GP 0.5 days, p=0.03), total use of opioids (GH 3.5 days vs GP 7 days, p<0.01) , of administration of parenteral nutrition (GH 24.5 days vs GP 20 days, p=0.03), and earlier start of enteral feeding (GH 11 days vs GP 7 days, p=0.03). No differences in survival after hospital discharge (93% vs 89%, p=0.63).

Conclusions:

the application of a standardized protocol was linked to a significant reduction in the time of abdominal closure, mechanical ventilation, parenteral nutrition, and opioids, with earlier initiation of enteral nutrition.

Palavras-chave : Gastroschisis; Reference Standards; Local Anesthesia.

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