Ectopia cordis: a novel palliative care technique.
Complete ectopia cordis in the newborn represents a significant management challenge. There are minimal data available to inform optimal clinical care for those infants with coexisting complex congenital heart disease who are therefore not candidates for surgical intervention. The exteriorisation of the heart and absence of the pericardial sac requires meticulous wound care to prevent desiccation of the myocardium and to minimise infection risk. Additionally, the technique selected must address the risk of occlusion of the cardiac vascular pedicle and abrasion between the mobile myocardium and dressing surface. We report a novel approach to wound management and integrated palliative care that enabled community-based care. Our patient, a full-term male infant with complete ectopia cordis was born in good condition by assisted vaginal delivery. He was discharged from hospital on day 8 and was cared for in the community until his demise from cardiac failure on day 15.
Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.|Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Mary Judith
MJ
Berry
Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Maria
M
Saito-Benz
Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Tisha
T
Klein
Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Brendon
B
Bowkett
Neonatal Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand.
Vaughan F
VF
Richardson
D054083:Ectopia Cordis / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care / Q000379:methods*
Congenital cardiac anomaly; Ectopia cordis; Neonatal palliative care