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Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease.

Publication ,  Journal Article
Einhorn, LM; Taicher, BM; Greene, NH; Reinstein, LJ; Jooste, EH; Campbell, MJ; Machovec, KA
Published in: Paediatr Anaesth
July 2018

BACKGROUND: Infants with congenital heart disease often require feeding tube placement to supplement oral intake. Gastrostomy tubes may be placed by either surgical or percutaneous endoscopic methods, but there is currently no data comparing outcomes of these procedures in this population. AIMS: The aim of our retrospective study was to investigate the perioperative outcomes between the 2 groups to determine if there are clinically significant differences. METHODS: We reviewed the charts of all infants with congenital heart disease at a single academic institution having isolated surgical or percutaneous endoscopic gastrostomy tube placement from January 2011 to December 2015. Anesthetic time, defined by cumulative minimum alveolar concentration hours of exposure to volatile anesthetic, was the primary outcome. Operative time, intraoperative complications, and postoperative intensive care admissions were secondary outcomes. RESULTS: One hundred and one infants with congenital heart disease were included in this study. Anesthetic exposure was shorter in the endoscopic group than the surgical group (0.20 MAC-hours vs 0.56 MAC-hours, 95% confidence interval 0.23, 0.49, P < .001). Average operative times were also shorter in the endoscopic gastrostomy vs the surgical group (8 ± 0.7 minutes vs 35 ± 1.3 minutes, 95% confidence interval 23.7, 31.0, P < .001). Adjusting for prematurity and preoperative risk category, the surgical group was associated with a 3.45 fold increase in the likelihood of a higher level of care postoperatively (95% confidence interval 1.20, 9.90, P = .02). CONCLUSION: In infants with congenital heart disease, percutaneous endoscopic gastrostomy placement is associated with reduced anesthetic exposure and fewer postoperative intensive care unit admissions compared to surgical gastrostomy.

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Published In

Paediatr Anaesth

DOI

EISSN

1460-9592

Publication Date

July 2018

Volume

28

Issue

7

Start / End Page

612 / 617

Location

France

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Male
  • Infant
  • Humans
  • Heart Defects, Congenital
  • Gastrostomy
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Einhorn, L. M., Taicher, B. M., Greene, N. H., Reinstein, L. J., Jooste, E. H., Campbell, M. J., & Machovec, K. A. (2018). Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease. Paediatr Anaesth, 28(7), 612–617. https://doi.org/10.1111/pan.13416
Einhorn, Lisa M., Brad M. Taicher, Nathaniel H. Greene, Leon J. Reinstein, Edmund H. Jooste, Michael J. Campbell, and Kelly A. Machovec. “Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease.Paediatr Anaesth 28, no. 7 (July 2018): 612–17. https://doi.org/10.1111/pan.13416.
Einhorn LM, Taicher BM, Greene NH, Reinstein LJ, Jooste EH, Campbell MJ, et al. Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease. Paediatr Anaesth. 2018 Jul;28(7):612–7.
Einhorn, Lisa M., et al. “Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease.Paediatr Anaesth, vol. 28, no. 7, July 2018, pp. 612–17. Pubmed, doi:10.1111/pan.13416.
Einhorn LM, Taicher BM, Greene NH, Reinstein LJ, Jooste EH, Campbell MJ, Machovec KA. Percutaneous endoscopic gastrostomy vs surgical gastrostomy in infants with congenital heart disease. Paediatr Anaesth. 2018 Jul;28(7):612–617.
Journal cover image

Published In

Paediatr Anaesth

DOI

EISSN

1460-9592

Publication Date

July 2018

Volume

28

Issue

7

Start / End Page

612 / 617

Location

France

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Male
  • Infant
  • Humans
  • Heart Defects, Congenital
  • Gastrostomy
  • Female