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Predictive Factors for a Negative Outcome in Initial Atropine Therapy of Infantile Hypertrophic Pyloric Stenosis.
MedLine Citation:
PMID:  23701208     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The predictive factors for a negative outcome in initial intravenous atropine (IA) therapy of infantile hypertrophic pyloric stenosis (IHPS) are unknown. Conservative therapy for IHPS is useful for infants because it does not have the risk of surgical and anesthetic stress, but some cases where patients undergoatropinetherapy result in failure. This study aimed to clarify the predictive markers for a negative outcome in initial atropinetherapy of IHPS. METHODS: Seventy-six patients with IHPS who were admitted to our institute from 1998 to 2011 were included in this study. The predictive risk factors of a negative outcome in initial atropine therapy for IHPS were evaluated. RESULTS: Thirty-one patients initially underwent non-operative therapy for IHPS during the study period. Of the 31 patients, 18 (58%) ceased projectile vomiting with intravenous and subsequent oral atropine administration. Univariate analysis showed that loss of body weight gain before administration, elevated urine potassium level at admission, and projectile vomiting occurring ≥5 times (PV≥5) for 3 days from IA administration were predictive risk factors for a negative outcome in IHPS. Multivariate analysis revealed that only PV≥5 for 3days after IA was independently associated with failure of atropine therapy for IHPS. CONCLUSIONS: PV≥5 for 3days after IAmay be a potentially predictive indicator for a negative outcome of atropine therapy in IHPS patients. Our results provide valuable information for determining whether early surgical intervention for IHPS or initial atropine therapy is the best option.
Authors:
Yuhki Koike; Keiichi Uchida; Makoto Nakazawa; Mikihiro Inoue; Masato Kusunoki; Yoshihide Tsukamoto
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-23
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  Pediatr Int     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-5-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
Affiliation:
Department of Pediatric Surgery, National Mie Hospital, Mie, Japan; Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
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