Peritoneal drainage in pneumoperitoneum in extremely low birth weight infants
The aim was to determine if peritoneal drainage (PD) is a suitable treatment for pneumoperitoneum in extremely low birth weight (ELBW) infants. A retrospective chart review of 42 ELBW infants with pneumoperitoneum at the University Hospital of Cologne between November 2014 and April 2017 was performed. Forty-two infants with a median birth weight of 645 g (interquartile range (IQR) 550, 806) and a median gestational age of 24.3 weeks (IQR 23.2, 25.6) were treated for pneumoperitoneum. Twenty-six (62%) received PD, and in ten (38%), the drain could be removed without further intervention. Infants in the PD group were of significantly lower birth weight (622g vs. 750 g), age (4.5 vs. 10.0 days), and weight at diagnosis (538 vs. 778 g). The mortality in the PD group was 15% at 90 days of life, but no patient deceased in the primary laparotomy group.
What is known:
• Pneumoperitoneum is traditionally treated with laparotomy, but placement of peritoneal drainage (PD) is a valuable treatment option.
• Previous randomized controlled trials have shown no significant differences in mortality for PD versus laparotomy.
What is new:
• In our cohort, 38% of the infants with PD could be saved from secondary laparotomy, but in the PD group there was a trend towards higher mortality.
• PD allows bridging the vulnerable first days of life until ELBW infants are in a more stable condition for possible laparotomy
KeywordsPreterm Laparotomy Peritoneal drainage Mortality Spontaneous intestinal perforation Necrotizing enterocolitis
Extremely low birth weight
Spontaneous intestinal perforation
Ilse Broekaert: data acquisition, analysis and data interpretation, drafting of the manuscript
Titus Keller: analysis and data interpretation, drafting of the manuscript
Daisy Schulten: analysis and data interpretation, critical revision
Christoph Huenseler: data acquisition, analysis and data interpretation, critical revision
Angela Kribs: study conception and design, analysis and data interpretation, critical revision
Martin Duebbers: study conception and design, analysis and data interpretation, drafting of the manuscript
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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