Chronic Severe Respiratory Insufficiency

Noah, Zehava L.; Budek, Cynthia Etzler

doi:10.1016/b978-1-4377-0755-7.00412-7

Cited by 3 publications

(5 citation statements)

References 28 publications

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“…We use the age-specific cut-off values to define high PCT level. Coagulopathy was defined as platelet count <100,000/mm 3 or INR >1.5 or activated prothrombin time >60 s ( 20 ). Thrombocytopenia was defined as a platelet count <150 × 10 9 /L ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

“…Coagulopathy was defined as platelet count <100,000/mm 3 or INR >1.5 or activated prothrombin time >60 s ( 20 ). Thrombocytopenia was defined as a platelet count <150 × 10 9 /L ( 20 ). Hyponatremia was defined as a serum sodium concentration (Na + ) <130 mEq/L ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

“…Thrombocytopenia was defined as a platelet count <150 × 10 9 /L ( 20 ). Hyponatremia was defined as a serum sodium concentration (Na + ) <130 mEq/L ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

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Risk Factors for Mortality in Neonatal Gastric Perforation: A Retrospective Cohort Study

Huang

Peng

et al. 2021

Front. Pediatr.

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Background: Neonatal gastric perforation is a rare but life-threatening issue. The aim of this study was to describe the clinical characteristics and prognosis of patients with neonatal gastric perforation and identify predictive factors for poor prognosis.Methods: This was a retrospective cohort study of patients with neonatal gastric perforation treated in a tertiary pediatric public hospital between April 2009 and October 2020. The enrolled patients were divided into survival and non-survival groups. Demographic information, clinical characteristics, laboratory and imaging features, and outcomes were collected from the electronic medical record. Univariate and multivariate logistic regression analyses were performed to obtain the independent factors associated with death risk. Additionally, we separated this population into two groups (pre-term and term groups) and explored the mortality predictors of these two groups, respectively.Results: A total of 101 patients with neonatal gastric perforation were included in this study. The overall survival rate was 70.3%. Seventy-one (70.3%) were pre-term neonates, and sixty-two (61.4%) were low-birth-weight neonates. The median age of onset was 3 days (range: 1–11 days). Abdominal distension [98 (97.0%) patients] was the most common symptom, followed by lethargy [78 (77.2%) patients], shortness of breath [60 (59.4%) patients] and vomiting [34 (33.7%) patients]. Three independent mortality risk factors were identified: shock (OR, 3.749; 95% CI, 1.247–11.269; p = 0.019), serum lactic acid > 2.5 mmol/L (5.346; 1.727–16.547; p = 0.004) and platelet count <150 × 109/L (3.510; 1.115–11.053; p = 0.032). There was a borderline significant association between sclerema neonatorum and total mortality (4.827; 0.889–26.220; p = 0.068). In pre-term infants, serum lactic acid > 2.5 mmol/L and platelet count <150 × 109/L remained independent risk factors for death. In term infants, the incidence of shock, coagulopathy, pH < 7.3, serum lactic acid > 2.5 mmol/L, and hyponatremia were statistically different between non-survival and survival groups.Conclusion: Shock, hyperlactatemia, and thrombocytopenia are independently associated with an increased risk of death in patients with neonatal gastric perforation. Identification of modifiable risk factors during the critical periods of life will contribute to the development of effective prevention and intervention strategies of neonatal gastric perforation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Risk Factors for Mortality in Neonatal Gastric Perforation: A Retrospective Cohort Study

Huang

Peng

et al. 2021

Front. Pediatr.

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“…Fever was defined as an axillary temperature of at least 37.3°C. Hyponatremia was defined as a serum sodium concentration (Na + ) < 130 mEq/L ( 17 ). Bloody stool was defined as visible blood in the stool.…”

Section: Methodsmentioning

confidence: 99%

Development and Validation of a Nomogram for Preoperative Prediction of Localization of Neonatal Gastrointestinal Perforation

Huang

Jin

et al. 2021

Front. Pediatr.

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Background: Information regarding the localization of gastrointestinal perforation is crucial for the following surgical procedure. This study was to determine the key indicators and develop a prediction model for the localization in neonates with gastrointestinal perforation.Methods: A nomogram to predict the location of neonatal gastrointestinal perforation was developed using a cohort of patients who underwent surgery between July 2009 and May 2021. Baseline variables were analyzed using logistics regression and nomogram developed using significant predictors. The predictive performance of the nomogram was assessed by the concordance index (C-index), calibration curve, and area under the receiver operating characteristic (ROC) curve (AUC). The nomogram was further validated in an integrated external cohort.Results: We investigated the data of 201 patients, of which 65 (32.3%) were confirmed with upper gastrointestinal perforation by surgery. Multivariate logistic regression analysis identified the following as independent predictors: preterm [OR: 5.014 (1.492–18.922)], time of onset [OR: 0.705 (0.582–0.829)], preoperative hemoglobin [OR:1.017 (1.001–1.033)], bloody stool: No [OR: 4.860 (1.270–23.588)], shock [OR: 5.790 (1.683–22.455)] and sepsis: No [OR 3.044 (1.124–8.581)]. Furthermore, the nomogram was effective in predicting the perforation site, with an AUC of 0.876 [95% confidence interval (CI): 0.830–0.923]. Internal validation showed that the average AUC was 0.861. Additionally, the model achieved satisfactory discrimination (AUC, 0.900; 95% CI, 0.826–0.974) and calibration (Hosmer-Lemeshow test, P = 0.4802) in external validation.Conclusions: The nomogram based on the six factors revealed good discrimination and calibration, suggesting good clinical utility. The nomogram could help surgeons predict the location of gastrointestinal perforation before surgery to make a surgical plan.

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“…While the clinical features are phenotypically variable, alveolar hypoventilation and rapid onset of obesity associated with hyperphagia are the most common. Association of this syndrome with neuroendocrine tumours led to the addition of the suffix ``NET´´ [2]. The anaesthetic and peri-operative management of these children is likely to be complex due to the large number of organ systems involved and has been infrequently reported in literature [3,4].…”

Section: Introductionmentioning

confidence: 99%

Peri‐operative management of a child with ROHHAD‐NET syndrome undergoing neural crest tumour excision

Puri

Yaddanapudi

Menon

2022

Anaesthesia Reports

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Summary A nine‐year‐old girl diagnosed with ROHHAD‐NET (rapid‐onset obesity, hypothalamic dysfunction, hypoventilation, autonomic dysfunction and neuroendocrine tumour) syndrome was scheduled for excision of a large paravertebral ganglioneuroma under general anaesthesia. Her comorbidities included hypothyroidism, diabetes insipidus and autonomic dysfunction. Intra‐ and postoperative complications included intra‐operative hypotension, long surgical time and prolonged postoperative ventilation. Complete weaning from ventilation was initially unsuccessful and she was ultimately discharged on domiciliary nasal BiPAP therapy. The peri‐operative care of children with this syndrome is challenging due to the involvement of multiple organ systems. In this report, we describe how pre‐operative optimisation, well‐planned intra‐operative management and intensive postoperative care are essential for a favourable outcome.

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Chronic Severe Respiratory Insufficiency

Cited by 3 publications

References 28 publications

Risk Factors for Mortality in Neonatal Gastric Perforation: A Retrospective Cohort Study

Risk Factors for Mortality in Neonatal Gastric Perforation: A Retrospective Cohort Study

Development and Validation of a Nomogram for Preoperative Prediction of Localization of Neonatal Gastrointestinal Perforation

Peri‐operative management of a child with ROHHAD‐NET syndrome undergoing neural crest tumour excision

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