Faculty Collaboration Database

Infectious outcomes of gastroschisis patients with intraoperative hypothermia. J Surg Res 2017 Jul;215:93-97

Date

07/10/2017

Pubmed ID

28688668

DOI

10.1016/j.jss.2017.03.053

Scopus ID

2-s2.0-85018273541 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Perioperative hypothermia decreases nutrient and oxygen delivery to tissues and, in adult studies, increases the risk of infectious complications (ICs). Gastroschisis (GS) places newborns at risk for hypothermia by nature of exposed viscera and excessive heat loss. Although hypothermia is a known cause of mortality in GS, the rate of ICs in this at-risk cohort has not yet been delineated.

MATERIALS AND METHODS: A retrospective cohort study was performed at our single tertiary-referral hospital, evaluating patient and operative characteristics of all GS infants who underwent operative closure. Intraoperative temperatures were recorded, defining hypothermia as mild (35.5°C-35.9°C), moderate (35.0°C-35.4°C), or severe (<35°C). Temperature nadirs, procedural and anesthesia duration were observed. The primary outcome was 30-d surgical site infections. Secondary measures included other ICs.

RESULTS: Among 43 GS neonates, 21 (48.8%) had intraoperative hypothermia, classified as mild in 2 (4.7%), moderate in 8 (18.6%), and severe in 11 (25.6%). Nineteen ICs occurred in 35.9% of patients, including 10 (23.3%) surgical site infections. There was no association between hypothermia and ICs. Patient and operative characteristics were similar between normothermic and hypothermic groups, except that normothermic infants were more likely to have silos placed with delayed closure than hypothermic patients (63.6% versus 23.8%, P = 0.01).

CONCLUSIONS: Infants with GS are at high risk for hypothermia and ICs, though newborns with silos were less subject to temperature lability. A multiinstitutional study with greater power is needed to further investigate the relationship between perioperative hypothermia and surgical ICs.

Author List

Landisch RM, Massoumi RL, Christensen M, Wagner AJ

Author

Amy Wagner MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Female
Gastroschisis
Humans
Hypothermia
Infant, Newborn
Intraoperative Complications
Male
Pilot Projects
Retrospective Studies
Risk Factors
Surgical Wound Infection
Treatment Outcome