title: Gastroschisis and omphalocele: retrospective study of initial postoperative management in the ICU.
abstract: OBJECTIVE
  The purpose of this study is to describe the management of infants with gastroschisis (G) and omphalocele (O) during the first 7 days after surgery.
  
  
  METHODS
  A retrospective review of all cases of O or G managed at the ICU of the Robert Debré Teaching Hospital between January 1993 and July 2000 was carried out.
  
  
  METHODS
  29 infants with G, 15 with O (12 unruptured O [UO] and 3 ruptured O [RO]).
  
  
  RESULTS
  Ventilatory support consisted of conventional mechanical ventilation (46 %) and/or in high-frequency oscillatory ventilation (61 %). After day 4, ventilatory requirements evaluated by mean airway pressure (MAP) differed significantly between G (n = 10/29) and O (n = 7/15; group vs. day of life, p = 0.04). The average of MAP measured on days 5, 6, and 7 was significantly higher in O than in G (14.7 +/- 3.0 versus 10.9 +/- 2.8, p < 0.01, respectively). Volume expansion was required at least once in 90 % of patients. Mean fluid requirements were significantly lower in UO than in G and in RO (41 +/- 31 ml/kg, 91 +/- 73 ml/kg, and 137 +/- 25 ml/kg, respectively; p = 0.02 for each comparison). Patients with G were significantly more likely to receive norepinephrine (59 % vs. 20 %, p = 0.027) than patients with O. Twenty-six infants with G (90 %) and 11 with O (73 %) were discharged alive from ICU.
  
  
  CONCLUSIONS
  Haemodynamic instability can be expected in patients with G or RO, and ventilatory requirements were higher in infants with O than in infants with G during the first week after surgery.
authors: Paediatric Intensive Care Unit, Robert Debré Teaching Hospital, Paris, France. sophie.aizenfisz@rdb.ap-hop-paris.fr
authors: S
authors: S
authors: Aizenfisz
authors: S
authors: S
authors: Dauger
authors: E
authors: E
authors: Gondon
authors: C
authors: C
authors: Saizou
authors: P
authors: P
authors: De Lagausie
authors: D
authors: D
authors: Luton
authors: Y
authors: Y
authors: Aigrain
authors: F
authors: F
authors: Beaufils