Theresa R Grover1, Beverly S Brozanski2, James Barry3, Isabella Zaniletti4, Jeanette M Asselin5, David J Durand5, Billie L Short6, Eugenia K Pallotto7, Francine Dykes8, Kristina M Reber9, Michael A Padula10, Jacquelyn R Evans10, Karna Murthy11. 1. University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: theresa.grover@childrenscolorado.org. 2. University of Pittsburgh School of Medicine and the Children's Hospital of Pittsburgh, Pittsburgh, PA. 3. University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. 4. Children's Hospital Association, Overland Park, KS. 5. Children's Hospital Oakland & Research Center, Oakland, CA. 6. George Washington University School of Medicine and Children's National Medical Center, Washington, DC. 7. University of Missouri School of Medicine and Children's Mercy Hospital, Kansas City, MO. 8. Emory University School of Medicine, Atlanta, GA. 9. Ohio State University School of Medicine and Nationwide Children's Hospital, Columbus, OH. 10. Perelman School of Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, PA. 11. Feinberg School of Medicine, Northwestern University & the Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Abstract
BACKGROUND/ PURPOSE: Infants with severe chronic lung disease (sCLD) may require surgical procedures to manage their medical problems; however, the scope of these interventions is undefined. The purpose of this study was to characterize the frequency, type, and timing of operative interventions performed in hospitalized infants with sCLD. METHODS: The Children's Hospital Neonatal Database was used to identify infants with sCLD from 24 children's hospital's NICUs hospitalized over a recent 16-month period. RESULTS: 556 infants were diagnosed with sCLD; less than 3% of infants had operations prior to referral and 30% were referred for surgical evaluation. In contrast, 71% of all sCLD infants received ≥1 surgical procedure during the CHND NICU hospitalization, with a mean of 3 operations performed per infant. Gastrostomy insertion (24%), fundoplication (11%), herniorrhaphy (13%), and tracheostomy placement (12%) were the most commonly performed operations. The timing of gastrostomy (PMA 48±10 wk) and tracheostomy (PMA 47±7 wk) insertions varied, and for infants who received both devices, only 33% were inserted concurrently (13/40 infants). CONCLUSIONS: A striking majority of infants with sCLD received multiple surgical procedures during hospitalizations at participating NICUs. Further work regarding the timing, coordination, perioperative complications, and clinical outcomes for these infants is warranted.
BACKGROUND/ PURPOSE:Infants with severe chronic lung disease (sCLD) may require surgical procedures to manage their medical problems; however, the scope of these interventions is undefined. The purpose of this study was to characterize the frequency, type, and timing of operative interventions performed in hospitalized infants with sCLD. METHODS: The Children's Hospital Neonatal Database was used to identify infants with sCLD from 24 children's hospital's NICUs hospitalized over a recent 16-month period. RESULTS: 556 infants were diagnosed with sCLD; less than 3% of infants had operations prior to referral and 30% were referred for surgical evaluation. In contrast, 71% of all sCLD infants received ≥1 surgical procedure during the CHND NICU hospitalization, with a mean of 3 operations performed per infant. Gastrostomy insertion (24%), fundoplication (11%), herniorrhaphy (13%), and tracheostomy placement (12%) were the most commonly performed operations. The timing of gastrostomy (PMA 48±10 wk) and tracheostomy (PMA 47±7 wk) insertions varied, and for infants who received both devices, only 33% were inserted concurrently (13/40 infants). CONCLUSIONS: A striking majority of infants with sCLD received multiple surgical procedures during hospitalizations at participating NICUs. Further work regarding the timing, coordination, perioperative complications, and clinical outcomes for these infants is warranted.