Abstract
Aims: A previous retrospective review of CDH cases repaired from 1996-2007 revealed a mortality rate comparable to other centres. A follow-on study was then begun to more accurately examine mortality, morbidity and any benefit of NJ tube placement in successful feeding establishment.
Methods: : Data were gathered from patient notes during their PICU and ward admissions and analysed using Microsoft Excel.
Results: From Oct 2007 to Jan 2010, there were 17 episodes of CDH repair among 15 patients. 3 patients died, giving a survival rate of 80% which is improved on the previous figure of 70%.
Patients had an average of 17days TPN [range 0-38] with an average of one episode of CONS sepsis per patient. 7 patients had an NJ tube passed, taking an average of 5.3days to achieve jejunal placement. One tube was sited radiologically, but successful placement failed completely in 3 patients. Mean time to establish full feeds was 21 days [range 1-65], but this was reduced to 3.8days in patients after an NJ was successfully sited.
Conclusions: Time to achieve full enteral feeds was significantly reduced post NJ tube placement. However, the failure to place an NJ in almost onethird of patients attempted must be noted, as must the 5 day delay in attaining successful tube position. We would recommend routine placement of NJ at the time of hernia repair. This would likely reduce TPN requirements, dependence on central venous access and episodes of sepsis.
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Neylon, O., Subramaniam, R. & Healy, M. 789 The Potential Benefit of Nj Tube Placement at the Time of Congenital Diaphragmatic Hernia Repair Surgery. Pediatr Res 68 (Suppl 1), 398 (2010). https://doi.org/10.1203/00006450-201011001-00789
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DOI: https://doi.org/10.1203/00006450-201011001-00789