Intraperitoneal microdialysis in the postoperative surveillance of infants undergoing surgery for congenital abdominal wall defect: A pilot study

Kirsten Risby; Mark B Ellebæk; Marianne S Jakobsen; Steffen Husby; Niels Qvist

doi:10.1016/j.jpedsurg.2015.02.066

Intraperitoneal microdialysis in the postoperative surveillance of infants undergoing surgery for congenital abdominal wall defect: A pilot study

J Pediatr Surg. 2015 Oct;50(10):1676-80. doi: 10.1016/j.jpedsurg.2015.02.066. Epub 2015 Mar 10.

Authors

Kirsten Risby¹, Mark B Ellebæk², Marianne S Jakobsen³, Steffen Husby¹, Niels Qvist⁴

Affiliations

¹ Hans Christian Andersen Children's Hospital, Odense University Hospital, 5000 Odense C, Denmark.
² Department of Surgery, Odense University Hospital, 5000 Odense C, Denmark.
³ Pediatric Department, Kolding Hospital, Kolding, Denmark.
⁴ Department of Surgery, Odense University Hospital, 5000 Odense C, Denmark. Electronic address: famqvist@dadlnet.dk.

PMID: 25783347
DOI: 10.1016/j.jpedsurg.2015.02.066

Abstract

Purpose: This study aims to investigate the safety and clinical implication of intraperitoneal microdialysis (MD) in newborns operated on for congenital abdominal wall defect.

Patients and methods: 13 infants underwent intraperitoneal microdialysis (9 with gastroschisis and 4 with omphalocele). MD samples were collected every four hours and the concentrations of lactate, glycerol, glucose and pyruvate were measured. The results of MD were compared between the group of infants with gastroschisis and the group with omphalocele. The duration of parenteral nutrition and tube feeding were compared for high and low levels of intraperitoneal lactate, glycerol, and glucose and lactate/pyruvate ratio respectively. High and low levels were defined as above or below the median value on day one.

Results: Results from intraperitoneal MD showed a significantly higher mean lactate concentration in the group of infants with gastroschisis compared with the group of infants with omphalocele. The median values were 6.19 mmol/l and 2.19 mmol/l, respectively (P=0.006). The results from MD in the six infants in the gastroschisis group who underwent secondary closure after Silo treatment were similar to those who underwent primary closure. None of the infants with omphalocele received parenteral nutrition whereas all of the infants with gastroschisis did. There was no significant difference in duration of parenteral nutrition or tube feeding, respectively, when comparing the gastroschisis children with high versus low intraperitoneal lactate values. Placement of the MD catheter in the intraperitoneal cavity was feasible and without any major complications.

Conclusion: Intraperitoneal MD is a safe procedure and an applicable method in surveillance of inflammatory changes in the peritoneal cavity in infants after operation for congenital abdominal wall defect. The true clinical value in infants with congenital wall defect remains unknown.

Keywords: Congenital abdominal wall defect; Gastroschisis; Intraperitoneal lactate; Intraperitoneal microdialysis; Omphalocele.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Abdominal Wall / surgery
Biomarkers / metabolism
Female
Gastroschisis / metabolism
Gastroschisis / surgery*
Hernia, Umbilical / metabolism
Hernia, Umbilical / surgery*
Humans
Infant
Infant, Newborn
Male
Microdialysis / methods*
Peritoneal Cavity
Pilot Projects
Postoperative Care / methods*
Treatment Outcome

Substances

Biomarkers