Journal of pediatric surgery · 2025
Failed Extubation After Primary Repair of Type C Esophageal Atresia: Frequency and Risk Factors.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Koo Donna C, Scalise P Nina, Chiu Megan Z, Izadi Shawn N, Kamran Ali, Mohammed Somala, Demehri Farokh R, Hansen Anne, Choi Sukgi, Zendejas Benjamin
Аннотация
PURPOSE: Reintubation after esophageal atresia and tracheoesophageal fistula (EA/TEF) repair is believed to increase the risk of anastomotic injury. However, some newborns fail initial extubation and require reintubation. This study explores the frequency and risk factors predictive of extubation failure in newborns after primary type C EA/TEF repair. We further evaluate the effect of extubation management strategies, such as the timing of extubation and the use of supportive non-invasive modalities.
METHODS: We conducted a single-center review of newborns with type C EA/TEF between 2010 and 2020. Patient characteristics and perioperative outcomes between successfully extubated and reintubated newborns were compared. Patients who underwent early extubation (postoperative day [POD] 0-1) were compared to those who underwent delayed extubation (POD ≥2). Patients were divided by the modality of noninvasive positive pressure ventilation to which they were extubated and outcomes were compared between groups.
RESULTS: Sixty-nine newborns underwent primary type C EA/TEF repair. Seven newborns (10 %) required a total of 10 reintubations. Patients who failed extubation had more concomitant congenital malformations, and newborns with congenital anomalies were 14 times more likely to require reintubation. There was no significant difference in reintubation, anastomotic leak, or stricture rate between those who underwent early versus delayed extubation. Newborns who were successfully extubated were more likely to be extubated to room air or nasal cannula.
CONCLUSION: Extubation failure occurred in 10% of patients and was significantly associated with the presence of multiple congenital anomalies. Individualized extubation strategies may optimize outcomes.
LEVEL OF EVIDENCE: III.
METHODS: We conducted a single-center review of newborns with type C EA/TEF between 2010 and 2020. Patient characteristics and perioperative outcomes between successfully extubated and reintubated newborns were compared. Patients who underwent early extubation (postoperative day [POD] 0-1) were compared to those who underwent delayed extubation (POD ≥2). Patients were divided by the modality of noninvasive positive pressure ventilation to which they were extubated and outcomes were compared between groups.
RESULTS: Sixty-nine newborns underwent primary type C EA/TEF repair. Seven newborns (10 %) required a total of 10 reintubations. Patients who failed extubation had more concomitant congenital malformations, and newborns with congenital anomalies were 14 times more likely to require reintubation. There was no significant difference in reintubation, anastomotic leak, or stricture rate between those who underwent early versus delayed extubation. Newborns who were successfully extubated were more likely to be extubated to room air or nasal cannula.
CONCLUSION: Extubation failure occurred in 10% of patients and was significantly associated with the presence of multiple congenital anomalies. Individualized extubation strategies may optimize outcomes.
LEVEL OF EVIDENCE: III.