دورية أكاديمية
أعرض في EDS

Diaphragmatic paralysis after phrenic nerve injury in newborns.

التفاصيل البيبلوغرافية
العنوان: Diaphragmatic paralysis after phrenic nerve injury in newborns.
المؤلفون: Rizeq YK; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: yrizeq@luriechildrens.org., Many BT; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: bmany@luriechildrens.org., Vacek JC; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: jvacek@luriechildrens.org., Reiter AJ; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: audra.reiter@northwestern.edu., Raval MV; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: mraval@luriechildrens.org., Abdullah F; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: fabdullah@luriechildrens.org., Goldstein SD; Ann and Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: sdgoldstein@luriechildrens.org.
المصدر: Journal of pediatric surgery [J Pediatr Surg] 2020 Feb; Vol. 55 (2), pp. 240-244. Date of Electronic Publication: 2019 Nov 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Saunders
Original Publication: New York.
مواضيع طبية MeSH: Diaphragm/*surgery , Paralysis, Obstetric/*etiology , Paralysis, Obstetric/*surgery , Phrenic Nerve/*injuries , Respiratory Paralysis/*etiology , Respiratory Paralysis/*surgery, Female ; Humans ; Infant, Newborn ; Length of Stay ; Male ; Paralysis, Obstetric/therapy ; Respiration, Artificial ; Respiratory Paralysis/therapy ; Retrospective Studies
مستخلص: Background: Phrenic nerve injury (PNI) from birth trauma is a recognized phenomenon, generally occurring with ipsilateral brachial plexus palsy (BPP). In severe cases, PNI results in diaphragm paresis (DP) and respiratory insufficiency. Surgical diaphragmatic plication (SDP) is a potential management strategy for patients with PNI and DP, but timing and outcomes associated with SDP have not been rigorously studied.
Methods: Records from 49 tertiary United States pediatric hospitals in the Pediatric Health Information System from 2004 to 2018 were analyzed. The study cohort included patients diagnosed with BPP from birth trauma who were documented to have PNI or DP. Patients who underwent congenital cardiac operations were excluded.
Results: A total of 5832 patients were identified with BPP from birth trauma during the study period, 122 (2%) of whom were found to have concomitant DP. Of those, 65 (53%) were male, 39 (32%) were infants of diabetic mothers, 80 (65%) required mechanical ventilation, and 33 (27%) underwent SDP. SDP was performed at a median (range) age of 36 (7-95) days. Median (range) total and postoperative hospital lengths of stay (LOS) were 34 (6-180) and 15 (4-132) days, respectively. There was also an observed increase in post-operative LOS with increase in age at operation.
Conclusion: Neonatal DP is rare and is managed with SDP in a minority of instances. Age at repair affects total and postoperative length of stay, proxies for resource utilization and morbidity. Repair prior to 45 days of life appears to result in a shorter postoperative hospital stay. This analysis will help guide surgeons with respect to indications and operative timing for infant DP.
Type of Study: Retrospective Comparative Study.
Level of Evidence: Level III.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Diaphragm paralysis; Diaphragm plication; Phrenic nerve injury
تواريخ الأحداث: Date Created: 20191124 Date Completed: 20200624 Latest Revision: 20200624
رمز التحديث: 20231215
DOI: 10.1016/j.jpedsurg.2019.10.038
PMID: 31757507
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-5037
DOI:10.1016/j.jpedsurg.2019.10.038