High surgical burden for infants with severe chronic lung disease (sCLD)

Theresa R. Grover*, Beverly S. Brozanski, James Barry, Isabella Zaniletti, Jeanette M. Asselin, David J. Durand, Billie L. Short, Eugenia K. Pallotto, Francine Dykes, Kristina M. Reber, Michael A. Padula, Jacquelyn R. Evans, Karna Murthy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1202-1205
Number of pages4
JournalJournal of pediatric surgery
Volume49
Issue number8
DOIs
StatePublished - Aug 2014

Keywords

  • Bronchopulmonary dysplasia (BPD)
  • Chronic lung disease (CLD)
  • Neonatal surgery
  • Tracheostomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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