title: Evolution of critically ill patients with gastroschisis from three tertiary centers.
abstract: OBJECTIVES AND INTRODUCTION: Gastroschisis is a congenital abdominal wall defect with increasing occurrence worldwide over the past 20-30 years. Our aim was to analyze the morbidity of newborns after gastroschisis closure, with emphasis on metabolic and hydroelectrolyte disturbances in patients at three tertiary university centers.
  
  
  METHODS
  From January 2003 to June 2009, the following patient data were collected retrospectively: (A) Background maternal and neonatal data: maternal age, prenatal diagnosis, type of delivery, Apgar scores, birth weight, gestational age and sex; (B) Surgical modalities: primary or staged closure; and (C) Hospital course: levels of serum sodium and levels of serum albumin in the two first postoperative days, number of ventilation days, other postoperative variables and survival. Statistical analyses were used to examine the associations between some variables.
  
  
  RESULTS
  163 newborns were included in the study. Primary closure of the abdominal defect was performed in 111 cases (68.1%). The mean serum sodium level was 127.4 ± 6.7 mEq/L, and the mean serum albumin level was 2.35 ± 0.5 g/dL. Among the correlations between variables, it was verified that hyponatremia and hypoalbuminemia correlated with the number of days on the ventilator but not with the number of days on total parenteral nutrition (TPN); mortality rate correlated with infection. The final survival rate was 85.9%.
  
  
  CONCLUSIONS
  In newborns with gastroschisis, more aggressive attention to hyponatremia and hypoalbuminemia would improve the outcome.
authors: Pediatric Surgery Division Pediatric Liver Transplantation Unit Laboratory of Research in Pediatric Surgery, Medical School, University of Sao Paulo, Sao Paulo, Brazil. uenist@usp.br
authors: Ana Cristina A
authors: AC
authors: Tannuri
authors: Lourenço
authors: L
authors: Sbragia
authors: Uenis
authors: U
authors: Tannuri
authors: Luanna M
authors: LM
authors: Silva
authors: Antonio José G
authors: AJ
authors: Leal
authors: Augusto Frederico S
authors: AF
authors: Schmidt
authors: Antonio G
authors: AG
authors: Oliveira-Filho
authors: Joaquim Murray
authors: JM
authors: Bustorff-Silva
authors: Yvone A M V A
authors: YA
authors: Vicente
authors: Maria de Fátima G S
authors: Mde F
authors: Tazima
authors: Flávio O
authors: FO
authors: Pileggi
authors: Alexandra L
authors: AL
authors: Camperoni
mesh_terms: D000418:Albumins / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D016638:Critical Illness; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D034141:Hypoalbuminemia / Q000517:prevention & control; D007010:Hyponatremia / Q000517:prevention & control; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012964:Sodium / Q000032:analysis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D012964:Sodium