In Situ and Home Care Nasopharyngeal Intubation Improves Respiratory Condition and Prevents Surgical Procedures in Early Infancy of Severe Cases of Robin Sequence.
OBJECTIVE
To evaluate the clinical outcome of infants with Robin Sequence (RS) and severe respiratory obstruction managed with nasopharyngeal intubation (NPI).


METHODS
This prospective study was conducted with 107 infants with RS admitted to the Hospital for Craniofacial Anomalies of the University of São Paulo (HRAC-USP), from July 2003 to June 2010, diagnosed with severe RS and treated with NPI. The infants were followed up for the first year of life. Clinical findings, morbidity, and mortality were recorded.


RESULTS
Of the 223 infants with RS admitted to the hospital in the period studied, 149 were diagnosed with severe respiratory distress and 107 (71.81%) matched all the inclusion criteria. Of those, 78 (73%) presented Isolated Robin Sequence and 29 (27%) presented other syndromes or anomalies associated with RS. NPI treatment lasted an average of 57 days and the mean hospitalization time was 18 days. Although all infants presented feeding difficulties, 85% were fed orally and only 15% underwent gastrostomy. Morbidity was 14% and no deaths occurred.


CONCLUSIONS
The children treated with the RS treatment protocol adopted at the HRAC-USP had improved respiratory and feeding difficulties, required a shorter hospitalization time, and presented low morbidity and mortality during the first year of life. The general outcome prevented surgical procedures in early infancy.
Department of Pediatrics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Sílvio Marchioni 3-20, 17043900 Bauru, SP, Brazil.
Isabel Cristina
IC
Drago Marquezini Salmen
Department of Pediatrics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Sílvio Marchioni 3-20, 17043900 Bauru, SP, Brazil.
Ilza
I
Lazarini Marques
D000402:Airway Obstruction / Q000401:mortality* / Q000534:rehabilitation* / Q000601:surgery; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000401:mortality* / Q000706:statistics & numerical data; D008297:Male; D010855:Pierre Robin Syndrome / Q000401:mortality* / Q000534:rehabilitation* / Q000601:surgery; D015995:Prevalence; D019651:Plastic Surgery Procedures / Q000401:mortality / Q000706:statistics & numerical data; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome