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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 100 patients with gastroschisis and omphalocele is presented. It is emphasized that gastroschisis generally has a strikingly homogeneous clinical presentation, while the omphalocele has a more heterogeneous clinical presentation, varying from the smallest to the largest, nearly incorrectable type. The main problem in the two groups is the problem of the closure of the defect. In gastroschisis there are, in addition, two problems related to the length of the intestinal tract and the tendency to peritonitis and septicaemia. In omphalocele, however, the major problem is the associated anomalies. The experience from the present material indicates that greater efforts must be used in the future in trying to avoid hypothermia, both during transportation and during operation. Furthermore, greater efforts must be made in closing the abdominal wall defect primarily in both groups of patients. More liberal use of respirator and total parenteral nutrition, mainly by peripheral veins, has obviously contributed to the improvement in our results from 1 60% mortality rate in the first nine-year period to a 37% mortality rate in the last nine-year period in the omphalocele group. Our best results have been obtained during the last 3 years with 2 deaths in the last 12 patients who all were treated by primary closure. In the gastroschisis group a survival rate of 69% in the whole series and of 74% in those who were primarily completely closed must be looked upon as progress in the light of earlier reports of survival rates of 36% to 43%.
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PMID:Gastroschisis and omphalocele. 16 May 85

From 1970 to 1987, 23 neonates with gastroschisis were treated at Kobe Children's Hospital. One patient died and 22 survived (96%). Seven patients were hypothermic upon arrival at the hospital, with body temperatures of 31.8 to 35.4 degrees C. Six patients were successfully managed by warm saline bathing (40 to 42 degrees C for one minute) to improve hypothermia. One patient who did not receive this rewarming procedure (body temperature, 31.8 degrees C) died of intractable metabolic disorders related to hypothermia. Ten patients were treated by primary fascial closure of the abdominal wall defect, eight by the skin flap method with secondary closure of the deliberately created abdominal hernia, and five by the silastic sac technique. Two patients required creation of intestinal stomas for ileal atresia. After surgery, 19 patients required ventilatory care with total paralysis (average 6.0 days). Nine patients required total parenteral nutrition (TPN), while 13 tolerated enteral feeding on days 3 to 11 (average, 6.0 days). In the latter 13 patients, intravenous fluid therapy was discontinued on day 11. Our experience suggests that (1) rewarming in a saline bath is effective treatment for hypothermia, (2) ventilatory assistance with total paralysis is mandatory, and (3) TPN can be avoided in 60% of the patients.
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PMID:Gastroschisis: a 17-year experience. 252 84

From 1984 to 1993, 25 neonates with gastroschisis were treated at Chianghua Christian Hospital (CCH). Twenty-one patients were outborn, and only four were inborn babies. Eighteen patients were treated by primary fascial closure of the abdominal wall defect and seven, by the silastic sac technique. One patient required creation of intestinal stomas for ileal atresia; Two patients received further operation because of pus formation and intestinal obstruction. Four patients (16%) had associated anomalies, including one ileal atresia, two malrotations and one deformity of the hand. Seven (28%) patients were small for their gestational age. Eight patients died (32%); 17 survived (68%). Nine patients (36%) were hypothermic upon arrival at the hospital, with body temperatures of 32.5 degrees C to 35.8 degrees C. Among those, three died of intractable metabolic disorders related to hypothermia and two who were hypothermal and acidotic, developed sepsis and expired. Six patients (24%) developed sepsis and only one survived. Metabolic acidosis related to hypothermia and sepsis were the major causes of death in this study (P values of 0.024 and 0.01 respectively). It is no doubt that an experienced pediatrician is essential for immediate neonatal care to prevent unnecessary insults.
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PMID:Hypothermia and sepsis: the major causes of mortality in gastroschisis. 860 56

Gastroschisis is an abdominal wall defect found in the newborn that requires immediate interventions in the delivery room. To provide appropriate management, clinicians must have a clear understanding of the etiology and pathophysiology of gastroschisis. Stabilization in the delivery room is important and begins with establishing an airway, preventing hypothermia, and protecting the exposed bowel from the environment. Surgical treatment is required in the early neonatal period. Adequate preparation prior to repair is essential to ensure optimal outcomes.
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PMID:Understanding gastroschisis: an abdominal wall defect. 993 95