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The Incidence and Relevance of Hematochezia in the Interstage Congenital Heart Population.
Strohacker, Courtney M; Cutler, Noah S; Yu, Sunkyung; Lowery, Ray E; Goldberg, Caren S.
Afiliación
  • Strohacker CM; Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA. courtmey@med.umich.edu.
  • Cutler NS; University of Michigan Medical School, Ann Arbor, MI, USA.
  • Yu S; Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA.
  • Lowery RE; Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA.
  • Goldberg CS; Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA.
Pediatr Cardiol ; 2024 Apr 25.
Article en En | MEDLINE | ID: mdl-38664297
ABSTRACT
Necrotizing enterocolitis (NEC) increases morbidity and mortality for infants with single ventricle heart disease (SVHD). While hematochezia often proceeds NEC not all hematochezia progresses to NEC. We aimed to examine the incidence, risk-factors, and outcomes associated with hematochezia and NEC for infants with SVHD. A single-center cohort study including SVHD patients requiring Stage I palliation from 12/2010 to 12/2015 was performed. Demographic, clinical, and outcome measures during the interstage period were abstracted from medical records. We defined hematochezia as blood in the stool without alternative etiology and NEC as systemic or intestinal signs concurrent with hematochezia and/or the presence of radiographic pneumatosis. Clinical characteristics and outcome measures were compared between patients with/without hematochezia and with/without NEC. Of 135 patients, 59(44%) had hematochezia and 20(15%) developed NEC. Demographic and operative factors were similar between patients with and without hematochezia. Patients with NEC were more often premature (15% vs 0%, p = 0.04), have lower birth weight (3.0 ± 0.6 vs 3.3 ± 0.5 kg, p = 0.03), longer cardiopulmonary bypass time (median 131 vs. 90 min, p = 0.02) and more often underwent unplanned cardiac catheterization (20% vs 3%, p = 0.04). Patients with hematochezia had more line days (p < 0.0001) and longer post-Stage-I length of stay (p < 0.0001) than those without hematochezia, and those with NEC had more line days than those without NEC (p = 0.02). Hematochezia is frequent following Stage-I palliation, however only one third of these patients develop NEC. Non-NEC Hematochezia is associated with a similar increase in line and hospital days. Further research is needed to identify methods to avoid over treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos