title: Does administering albumin to postoperative gastroschisis patients improve outcome?
abstract: OBJECTIVE
  Newborns who undergo surgery for gastroschisis correction may present with oliguria, anasarca, prolonged postoperative ileus, and infection. New postoperative therapeutic procedures were tested with the objective of improving postoperative outcome.
  
  
  METHODS
  One hundred thirty-six newborns participated in one of two phases. Newborns in the first phase received infusions of large volumes of crystalloid solution and integral enteral formula, and newborns in the second phase received crystalloid solutions in smaller volumes, with albumin solution infusion when necessary and the late introduction of a semi-elemental diet. The studied variables were serum sodium and albumin levels, the need for albumin solution expansion, the occurrence of anasarca, the length of time on parenteral nutrition, the length of time before initiating an enteral diet and reaching a full enteral diet, orotracheal intubation time, length of hospitalization, and survival rates.
  
  
  RESULTS
  Serum sodium levels were higher in newborns in the second phase. There was a correlation between low serum sodium levels and orotracheal intubation time; additionally, low serum albumin levels correlated with the length of time before the initiation of an oral diet and the time until a full enteral diet was reached. However, the discharge weights of newborns in the second phase were higher than in the first phase. The other studied variables, including survival rates (83.4% and 92.0%, respectively), were similar for both phases.
  
  
  CONCLUSIONS
  The administration of an albumin solution to newborns in the early postoperative period following gastroschisis repair increased their low serum sodium levels but did not improve the final outcome. The introduction of a semi-elemental diet promoted an increase in body weight at the time of discharge.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, Pediatric Surgery Division, Pediatric Liver Transplantation Unit, Brazil.
authors.forename: Ana Cristina A
authors.initials: AC
authors.lastname: Tannuri
authors.forename: Luanna M
authors.initials: LM
authors.lastname: Silva
authors.forename: Antonio José G
authors.initials: AJ
authors.lastname: Leal
authors.forename: Augusto César F de
authors.initials: AC
authors.lastname: Moraes
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
mesh_terms: D000418:Albumins / Q000008:administration & dosage* / Q000009:adverse effects; D000077324:Crystalloid Solutions; D004487:Edema / Q000453:epidemiology; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D020139:Gastroschisis / Q000097:blood / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007010:Hyponatremia / Q000517:prevention & control; D007231:Infant, Newborn; D007552:Isotonic Solutions / Q000008:administration & dosage; D007902:Length of Stay / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D012709:Serum Albumin / Q000032:analysis*; D012964:Sodium / Q000097:blood*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D012709:Serum Albumin; D012964:Sodium