| Peritoneal drainage does not stabilize extremely low birth weight infants with perforated bowel: data from the NET Trial. | |
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MedLine Citation:
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PMID: 20152345 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Proponents of peritoneal drainage (PD) hypothesize that it allows stabilization before laparotomy. We examined this hypothesis by comparing clinical status before and after either PD or primary laparotomy (LAP). METHODS: In an ethically approved, international, prospective randomized controlled trial (2002-2006), extremely low birth weight (<1000 g) infants with pneumoperitoneum received primary PD (n = 35) or LAP (n = 34). Physiologic data were collected prospectively and organ failure scores calculated and compared between preprocedure and day 1 after procedure. Data, expressed as mean +/- SD or median (range), were analyzed using appropriate statistical tests. RESULTS: There was no postprocedure improvement in either PD or LAP group comparing heart rate (PD, P = 1.0; LAP, P = .6), blood pressure (PD, P = .6; LAP, P = .8), inotrope requirement (PD, P = .2; LAP, P = .3), or Arterial partial pressure of oxygen/fraction of inspired oxygen ratio (PD, P = .1; LAP, P = .5). Infants managed with PD had a worsening cardiovascular status (P = .05). There were no differences in total organ failure score in either group (PD, P = .5; LAP, P = 1). Only 4 infants survived with PD alone with no difference between preprocedure and postprocedure organ failure score (P = .4). CONCLUSIONS: Peritoneal drainage does not immediately improve clinical status in extremely low birth weight infants with bowel perforation. The use of PD as a stabilizing or temporizing measure is not supported by these results. |
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Authors:
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Clare M Rees; Simon Eaton; A Kate Khoo; Edward M Kiely; ; Agostino Pierro |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 45 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-15 Completed Date: 2010-04-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 324-8; discussion 328-9 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Pediatric Surgery, UCL Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London WC1N 1EH, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Drainage
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methods* Enterocolitis, Necrotizing / surgery* Humans Infant, Extremely Low Birth Weight / physiology Infant, Newborn Infant, Premature Intestinal Perforation / surgery* Laparotomy / methods* Multiple Organ Failure / diagnosis, epidemiology Peritoneum / surgery Pneumoperitoneum / surgery Postoperative Care Postoperative Complications / diagnosis, epidemiology Preoperative Care Risk Factors Severity of Illness Index Survival Analysis Treatment Outcome |
| Investigator | |
Investigator/Affiliation:
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A Nika / ; P Gamba / ; M Zamparelli / ; G Jawaheer / ; S Clarke / ; M Miserez / ; M Davenport / ; P Bagolan / ; F Morini / ; V P Carnielli / ; A Calisti / ; C A Yeung / ; P K H Tam / ; S Marven / ; P Morreau / ; J Hamill / ; C Gitzelmann / ; R Surana / ; M H?llwarth / ; F Beyerlein / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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