作者
Mark Bishay, Luca Giacomello, Giuseppe Retrosi, Mandela Thyoka, Massimo Garriboli, Joe Brierley, Louise Harding, Stephen Scuplak, Kate M Cross, Joe I Curry, Edward M Kiely, Paolo De Coppi, Simon Eaton, Agostino Pierro
发表日期
2013/12/1
来源
Annals of surgery
卷号
258
期号
6
页码范围
895-900
出版商
LWW
简介
Objective:
We aimed to evaluate the effect of thoracoscopy in neonates on intraoperative arterial blood gases, compared with open surgery.
Background:
Congenital diaphragmatic hernia (CDH) and esophageal atresia with tracheoesophageal fistula (EA/TEF) can be repaired thoracoscopically, but this may cause hypercapnia and acidosis, which are potentially harmful.
Methods:
This was a pilot randomized controlled trial. The target number of 20 neonates (weight> 1.6 kg) were randomized to either open (5 CDH, 5 EA/TEF) or thoracoscopic (5 CDH, 5 EA/TEF) repair. Arterial blood gases were measured every 30 minutes intraoperatively, and compared by multilevel modeling, presented as mean and difference (95% confidence interval) from these predictions.
Results:
Overall, the intraoperative PaCO 2 was 61 mm Hg in open and 83 mm Hg [difference 22 mm Hg (2 to 42); P= 0.036] in thoracoscopy and the pH was 7 …
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