J Korean Soc Neonatol. Search

CLOSE


Journal of the Korean Society of Neonatology 2001;8(2):187-200.
Published online November 1, 2001.
Safety of Neonatal Surgery in Neonatal Intensive Care Unit Versus Operating Room.
Jin A Lee, Do Hyeon Kim, Heui Seung Jo, June Dong Park, Jeong Ryul Lee, Beyong Il Kim, Young Suk Yu, Kwi Won Park, Jung Hwan Choi
1Departments of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
2Departments of Thoracic Surgery, Seoul National University College of Medicine, Seoul, Korea.
3Departments of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
4Departments of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea.
신생아 중환자실에서 시행되는 수술의 안전성 - 미숙아 망막증에 대한 광응고술과 신생아 동맥관 개존증의 수술적 결찰을 중심으로 -
, , , , , , , ,
1
2
3
4
Abstract
PURPOSE
A transport of a critically ill infant, especially preterm infant, to an operating room (OR) from a neonatal intensive care unit (NICU) has special dangers like incidental removal of an intravenous line or a chest tube, extubation, stopping of vital sign monitoring, hypothermia and postanesthetic apnea, which could be fatal to the infant. An operation in a NICU, however, has high risk of sepsis and shortage of specialized staffs and equipments. Thus, it is generally favored so far to perform a surgery in an OR. We assessed the safety of surgery in a NICU.
METHODS
66 infants underwent operation in the NICU of Seoul National University Children's Hospital from January of 1995 to April of 2001. There were 30 cases of cryotherapy or laser photocoagulation for retinopathy of prematurity (ROP), 17 of peritoneal drainage catheter insertion, 10 of patent ductus arteriosus (PDA) ligation, 8 of extraventricular drainage, and 1 of laparotomy and peritoneal lavage. This study was conducted focusing on ROP and PDA patients. 28 cases of photocoagulation and 10 cases of PDA ligation conducted in the NICU were compared each other with 10 cases of photocoagulation and 10 cases of PDA ligation in the OR about surgical outcome and complications using retrospective medical record inspection.
RESULTS
Regarding ROP, there was no big difference between the two groups in light of the clinical factors and the status of an infant before and after an operation except that inspiratory fraction of oxygen (FiO2) before an operation in the NICU group was higher than that of the other group. A total operation time was longer and there were more variations of weight, body temperature and blood pressure in the OR group. A higher rise of the mean airway pressure (MAP) and higher frequency of intraoperative hypothermia were found in the OR group and there was 1 case of extubation during an operation. The postoperative retinal detachment and the postanesthetic apnea were more frequent in the OR group. Regarding PDA, no big difference was found between the two groups in light of the clinical factors and the status of an infant except that the gestational age at birth was smaller and cardiac failure was more frequent in the NICU group. The total operation time was longer and the rises of FiO2 and MAP were higher in the OR group. There was no significant difference in operation results and postoperative complications.
CONCLUSION
In light of the safety, the results, and the complications of an operation, no significant difference was found between the two groups. Accordingly, in case of ROP and PDA of a premature baby, We came to a conclusion that a NICU could be used as safe an operation place as an OR.
Key Words: Neonatal surgery, Neonatal intensive care unit, Retinopathy of prematurity, Patent ductus arteriosus


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
34, Sajik-ro 8–gil(King’s Gargen 3 Block 1207), Jongno-gu, Seoul 03174, Republic of Korea
Tel: +82-2-730-1993    Fax: +82-2-730-1994    E-mail: neonate2002@hanmail.net                

Copyright © 2022 by The Korean Society of Neonatology.

Developed in M2PI

Close layer
prev next