Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes

Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Eva Sorensen [verfasserIn] Connie Yu [verfasserIn] Shu-Ling Chuang [verfasserIn] Paola Midrio [verfasserIn] Leopoldo Martinez [verfasserIn] Mathew Nash [verfasserIn] Ingo Jester [verfasserIn] Amulya K. Saxena [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	esophageal perforation neonates nasogastric tube management outcomes

Übergeordnetes Werk:	In: Children - MDPI AG, 2014, 10(2023), 2, p 217
Übergeordnetes Werk:	volume:10 ; year:2023 ; number:2, p 217

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/children10020217

Katalog-ID:	DOAJ080983146

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allfields	10.3390/children10020217 doi (DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93 DE-627 ger DE-627 rakwb eng RJ1-570 Eva Sorensen verfasserin aut Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. esophageal perforation neonates nasogastric tube management outcomes Pediatrics Connie Yu verfasserin aut Shu-Ling Chuang verfasserin aut Paola Midrio verfasserin aut Leopoldo Martinez verfasserin aut Mathew Nash verfasserin aut Ingo Jester verfasserin aut Amulya K. Saxena verfasserin aut In Children MDPI AG, 2014 10(2023), 2, p 217 (DE-627)768093007 (DE-600)2732685-8 22279067 nnns volume:10 year:2023 number:2, p 217 https://doi.org/10.3390/children10020217 kostenfrei https://doaj.org/article/fdb7e3188d064868a907ccc0cfa76e93 kostenfrei https://www.mdpi.com/2227-9067/10/2/217 kostenfrei https://doaj.org/toc/2227-9067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2023 2, p 217
spelling	10.3390/children10020217 doi (DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93 DE-627 ger DE-627 rakwb eng RJ1-570 Eva Sorensen verfasserin aut Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. esophageal perforation neonates nasogastric tube management outcomes Pediatrics Connie Yu verfasserin aut Shu-Ling Chuang verfasserin aut Paola Midrio verfasserin aut Leopoldo Martinez verfasserin aut Mathew Nash verfasserin aut Ingo Jester verfasserin aut Amulya K. Saxena verfasserin aut In Children MDPI AG, 2014 10(2023), 2, p 217 (DE-627)768093007 (DE-600)2732685-8 22279067 nnns volume:10 year:2023 number:2, p 217 https://doi.org/10.3390/children10020217 kostenfrei https://doaj.org/article/fdb7e3188d064868a907ccc0cfa76e93 kostenfrei https://www.mdpi.com/2227-9067/10/2/217 kostenfrei https://doaj.org/toc/2227-9067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2023 2, p 217
allfields_unstemmed	10.3390/children10020217 doi (DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93 DE-627 ger DE-627 rakwb eng RJ1-570 Eva Sorensen verfasserin aut Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. esophageal perforation neonates nasogastric tube management outcomes Pediatrics Connie Yu verfasserin aut Shu-Ling Chuang verfasserin aut Paola Midrio verfasserin aut Leopoldo Martinez verfasserin aut Mathew Nash verfasserin aut Ingo Jester verfasserin aut Amulya K. Saxena verfasserin aut In Children MDPI AG, 2014 10(2023), 2, p 217 (DE-627)768093007 (DE-600)2732685-8 22279067 nnns volume:10 year:2023 number:2, p 217 https://doi.org/10.3390/children10020217 kostenfrei https://doaj.org/article/fdb7e3188d064868a907ccc0cfa76e93 kostenfrei https://www.mdpi.com/2227-9067/10/2/217 kostenfrei https://doaj.org/toc/2227-9067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2023 2, p 217
allfieldsGer	10.3390/children10020217 doi (DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93 DE-627 ger DE-627 rakwb eng RJ1-570 Eva Sorensen verfasserin aut Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. esophageal perforation neonates nasogastric tube management outcomes Pediatrics Connie Yu verfasserin aut Shu-Ling Chuang verfasserin aut Paola Midrio verfasserin aut Leopoldo Martinez verfasserin aut Mathew Nash verfasserin aut Ingo Jester verfasserin aut Amulya K. Saxena verfasserin aut In Children MDPI AG, 2014 10(2023), 2, p 217 (DE-627)768093007 (DE-600)2732685-8 22279067 nnns volume:10 year:2023 number:2, p 217 https://doi.org/10.3390/children10020217 kostenfrei https://doaj.org/article/fdb7e3188d064868a907ccc0cfa76e93 kostenfrei https://www.mdpi.com/2227-9067/10/2/217 kostenfrei https://doaj.org/toc/2227-9067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2023 2, p 217
allfieldsSound	10.3390/children10020217 doi (DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93 DE-627 ger DE-627 rakwb eng RJ1-570 Eva Sorensen verfasserin aut Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP. esophageal perforation neonates nasogastric tube management outcomes Pediatrics Connie Yu verfasserin aut Shu-Ling Chuang verfasserin aut Paola Midrio verfasserin aut Leopoldo Martinez verfasserin aut Mathew Nash verfasserin aut Ingo Jester verfasserin aut Amulya K. Saxena verfasserin aut In Children MDPI AG, 2014 10(2023), 2, p 217 (DE-627)768093007 (DE-600)2732685-8 22279067 nnns volume:10 year:2023 number:2, p 217 https://doi.org/10.3390/children10020217 kostenfrei https://doaj.org/article/fdb7e3188d064868a907ccc0cfa76e93 kostenfrei https://www.mdpi.com/2227-9067/10/2/217 kostenfrei https://doaj.org/toc/2227-9067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2023 2, p 217
language	English
source	In Children 10(2023), 2, p 217 volume:10 year:2023 number:2, p 217
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authorswithroles_txt_mv	Eva Sorensen @@aut@@ Connie Yu @@aut@@ Shu-Ling Chuang @@aut@@ Paola Midrio @@aut@@ Leopoldo Martinez @@aut@@ Mathew Nash @@aut@@ Ingo Jester @@aut@@ Amulya K. Saxena @@aut@@
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Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). 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title	Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes
ctrlnum	(DE-627)DOAJ080983146 (DE-599)DOAJfdb7e3188d064868a907ccc0cfa76e93
title_full	Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes
author_sort	Eva Sorensen
journal	Children
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lang_code	eng
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author_browse	Eva Sorensen Connie Yu Shu-Ling Chuang Paola Midrio Leopoldo Martinez Mathew Nash Ingo Jester Amulya K. Saxena
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title_sort	iatrogenic neonatal esophageal perforation: a european multicentre review on management and outcomes
callnumber	RJ1-570
title_auth	Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes
abstract	Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP.
abstractGer	Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP.
abstract_unstemmed	Background: The aim of this multicenter retrospective study and literature review was to review management and outcomes of neonatal esophageal perforation (NEP). Methods: Protocol data were collected from four European Centers on gestational age, factors surrounding feeding tube insertion, management and outcomes. Results: The 5-year study period (2014–2018) identified eight neonates with median gestational age of 26 + 4 weeks (23 + 4–39) and median birth weight 636 g (511–3500). All patients had NEP from enterogastric tube insertions, with the perforation occurring at median 1st day of life (range 0–25). Seven/eight patients were ventilated (two/seven-high frequency oscillation). NEP became apparent on first tube placement (<i<n</i< = 1), first change (<i<n</i< = 5), and after multiple changes (<i<n</i< = 2). Site of perforation was known in six (distal <i<n</i< = 3, proximal <i<n</i< = 2 and middle <i<n</i< = 1). Diagnosis was established by respiratory distress (<i<n</i< = 4), respiratory distress and sepsis (<i<n</i< = 2) and post-insertion chest X-ray (<i<n</i< = 2). Management in all patients included antibiotics and parenteral nutrition with two/eight receiving steroids and ranitidine, one/eight steroids only and one/eight ranitidine only. One neonate had a gastrostomy inserted, while in another an enterogastric tube was orally successfully re-inserted. Two neonates developed pleural effusion and/or mediastinal abscess requiring chest tube. Three neonates had significant morbidities (related to prematurity) and there was one death 10 days post-perforation (related to prematurity complications). Conclusions: NEP during NGT insertion is rare even in premature infants after evaluating data from four tertiary centers and reviewing the literature. In this small cohort, conservative management seems to be safe. A larger sample size will be necessary to answer questions on efficacy of antibiotics, antacids and NGT re-insertion time frame in NEP.
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container_issue	2, p 217
title_short	Iatrogenic Neonatal Esophageal Perforation: A European Multicentre Review on Management and Outcomes
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author2	Connie Yu Shu-Ling Chuang Paola Midrio Leopoldo Martinez Mathew Nash Ingo Jester Amulya K. Saxena
author2Str	Connie Yu Shu-Ling Chuang Paola Midrio Leopoldo Martinez Mathew Nash Ingo Jester Amulya K. Saxena
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up_date	2024-07-03T17:38:16.732Z
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