Surgical treatment of esophageal atresia with lower tracheoesophageal fistula in an extremely preterm infant (510 g, 25 + 5 weeks): a case report

Abstract Background The surgical management of esophageal atresia in extreme-low-birth-weight infants (< 1000 g) is challenging. We report on an extreme-low-birth-weight infant who was extremely preterm (510 g, 25 + 5 weeks) and of prenatally unknown Gross type C esophageal atresia. Case presentation After resuscitation and intubation, the tracheoesophageal fistula was closed on the first day of life in the neonatal intensive care unit via an extrapleural approach using a titanium clip. On the sixth day of life, the Caucasian child was extubated. To minimize the operative trauma in the initial neonatal period, we prolonged gastrostomy placement until the 22nd day of life (weight 725 g). At the age of 3 months (weight 2510 g), thoracoscopic esophageal anastomosis was performed. The postoperative course was unremarkable. During the further clinical course, eight esophageal dilations were necessary. Currently, the patient swallows without difficulties at the age of 4 years and thrives well [15 kg (Percentile 28); 100 cm (Percentile 24)]. Conclusions Our case shows that minimized postnatal surgical trauma with primary tracheoesophageal fistula closure at the bedside, delayed gastrostomy, and minimally invasive esophageal repair after substantial weight gain (> 2.5 kg) is a good strategy for esophageal atresia/tracheoesophageal fistula in extreme-low-birth-weight infants.

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Lower esophageal banding in extremely low birth weight infants with esophageal atresia and tracheoesophageal fistula is a life saving practice followed by a successful delayed primary thoracoscopy reconstruction

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2014.10.055 ◽

2015 ◽

Vol 50 (3) ◽

pp. 489-492 ◽

Cited By ~ 8

Author(s):

Loren Margain ◽

Eduardo Perez-Etchepare ◽

François Varlet ◽

Manuel Lopez

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Esophageal Atresia ◽

Tracheoesophageal Fistula ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Life Saving

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Outcome of primary repair in extremely and very low-birth-weight infants with esophageal atresia/distal tracheoesophageal fistula

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2017.05.011 ◽

2017 ◽

Vol 52 (10) ◽

pp. 1567-1570 ◽

Cited By ~ 8

Author(s):

Andreas Schmidt ◽

Florian Obermayr ◽

Justus Lieber ◽

Christian Gille ◽

Frank Fideler ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Esophageal Atresia ◽

Tracheoesophageal Fistula ◽

Very Low Birth Weight ◽

Primary Repair ◽

Low Birth Weight Infants

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961 Incidence of Hypothermia in Low Birth Weight Infants Admitted to the Neonatal Intensive Care Unit Between 2002 and 2009

Pediatric Research ◽

10.1203/00006450-201011001-00961 ◽

2010 ◽

Vol 68 ◽

pp. 479-480 ◽

Cited By ~ 1

Author(s):

S A Jaleel ◽

C Mcdermott ◽

N Mccallion

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Low Birth Weight Infants

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Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units

Advances in Medical Sciences ◽

10.1016/j.advms.2015.09.002 ◽

2016 ◽

Vol 61 (1) ◽

pp. 90-95 ◽

Cited By ~ 4

Author(s):

Jadwiga Wójkowska-Mach ◽

T. Allen Merritt ◽

Maria Borszewska-Kornacka ◽

Joanna Domańska ◽

Ewa Gulczyńska ◽

...

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Neonatal Intensive Care Units ◽

Low Birth Weight Infants

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Very Low Birth Weight Outcomes

PEDIATRICS ◽

10.1542/peds.89.2.357a ◽

1992 ◽

Vol 89 (2) ◽

pp. 357-357

Author(s):

HELEN HARRISON

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Meta Analysis ◽

Low Birth Weight Infants ◽

Randomized Controlled Clinical Trials ◽

Weight Outcomes ◽

Term Evaluation

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.

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Reticulocyte Count: The Forgotten Factor in Transfusion Decisions for Extremely Low Birth Weight Infants

American Journal of Perinatology ◽

10.1055/s-0041-1736598 ◽

2021 ◽

Author(s):

Daniel Nakhla ◽

Alla Kushnir ◽

Rafat Ahmed ◽

Vineet Bhandari ◽

Krystal Hunter ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care ◽

Reticulocyte Count ◽

Retrospective Chart Review ◽

Extremely Low Birth Weight ◽

Positive Trend ◽

Reference Ranges ◽

Low Birth Weight Infants ◽

Packed Red Blood Cells

Objective Extremely low birth weight (ELBW) infants often receive transfusions of packed red blood cells (PRBCs). Long-term outcomes of infants treated with liberal versus restricted transfusion criteria have been evaluated with conflicting results. Clinicians incorporate a reticulocyte count (RC) in their transfusion decisions. There is a lack of information on reference ranges for RCs in growing ELBW infants and whether infant's chronologic age or corrected gestational age (GA) generates a specific trend in the RCs. Our aim was to evaluate the levels of RCs obtained from ELBW infants over the course of the initial hospitalization. Study Design A retrospective chart review of ELBW infants treated in the neonatal intensive care unit (NICU) and had RCs performed. We analyzed the RCs to observe trends based on the chronologic age and corrected GA. Results A total of 738 RCs were analyzed. A positive trend in RCs that reached a peak at 32 to 34 weeks' corrected GA and then experienced a downward trend was observed. Conclusion Our report examines a very common hematologic test that is theoretically helpful but is in need of guidelines concerning the appropriate frequency of testing and its utility in making transfusion decisions in ELBW infants. Key Points

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Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019

Clinical and Experimental Pediatrics ◽

10.3345/cep.2019.00822 ◽

2020 ◽

Vol 63 (8) ◽

pp. 284-290 ◽

Cited By ~ 1

Author(s):

Jang Hoon Lee ◽

YoungAh Youn ◽

Yun Sil Chang ◽

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Annual Reports ◽

Long Term Outcomes ◽

Post Discharge ◽

Low Birth Weight Infants ◽

Korean Society

Korea currently has the world’s lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%–1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1–2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%–6.6% in Korea. Bilateral blindness was reported in 0.2%–0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%–1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

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A Prospective Study on Retinopathy of Prematurity in a Teritiary Care Center

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.1.14 ◽

2020 ◽

Vol 8 (1) ◽

pp. 58-60

Author(s):

Mahaboob Basha Kallur ◽

K. Muralidhar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Care Center ◽

Low Birth Weight Infants ◽

Cross Sectional ◽

Retinal Neovascularisation ◽

Premature Babies ◽

Low Birth Weight Babies

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative retinopathy which occurs mostly in premature babies. The pathological change in ROP is peripheral retinal neovascularisation which may regress completely or leave sequelae from mild myopia to bilateral total blindness. International classification of ROP helped in uniform documentation and staging of ROP. In India, the incidence of ROP is between 38 and 51.9 p.c among low-birth-weight infants. Aim & Objectives: To estimate the incidence of ROP among premature and / or low birth weight babies who were born and admitted to neonatal intensive care unit and attending neonatal follow-up clinic.Subjects and Methods:A hospital based, prospective analytical cross-sectional study was conducted in Department of Pediatrics at Shadan Institute of Medical Sciences, Teaching hospital and research center, Hyderabad, Telangana for a period of 6 months from 1st October 2018 to 31st March 2019. Prior to the study initiation, ethical clearance was obtained and written consent was taken from the parents of the respective babies. The study subjects included premature babies (less than or equal to 35 weeks of gestation) or low birth weight babies (less than or equal to 1500 grams). A predesigned, pre-tested, semi-structured proforma was used to collected the data. The data was collected, entered in Microsoft excel-2013 and analyzed using SPSS version-22 (trial). Data was presented in percentages, proportions and figures.Result:The ROP incidence in the study group was reported among 17.1 p.c of the study subjects.Conclusion:Low birth weight and prematurity are important risk factors for ROP.

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