PROFILE OF NEWBORNS SUBMITTED TO SURGERY IN THE INTENSIVE CARE UNIT

Abstract

INTRODUCTION: Improvements in pediatric surgical outcomes are partly attributable to major advances in better understanding of neonatal physiology, specialized pediatric anesthesia, neonatal intensive care, including sophisticated cardiopulmonary support, use of parenteral nutrition and adjustments in fluid management, refinement of surgical technique and advances in surgical technology, including minimally invasive options, which further reduced operative mortality in neonates. OBJECTIVE: To analyze the profile of patients undergoing surgery in a neonatal intensive care unit. METHOD: Retrospective analytical cross-sectional study with survey of all cases of surgery performed on newborns admitted to the Neonatal Intensive Care Unit of the Hospital and Maternidade Dona Íris (HMDI). RESULTS: We analyzed 523 medical records that correspond to the number of patients admitted to the Neonatal ICU of HMDI in 2018 and 2019 and of these 78 underwent some type of surgery corresponding to 14.9% of NBs. The profile of these patients is of gestational age between 33 to <37 weeks 31 (40%), weighing> 2500g 35 (45%), male 45 (58%), born by cesarean section 49 (63%), without post complications - surgical 41 (53%). The predominant type of surgery was a thoracostomy with a drain 21 (27%) followed by a gastroise 11 (14%). In the comparison between gestational age and type of surgery, we found: <28 weeks thoracostomy with drain, 29 to <32 weeks thoracostomy with drain and herniorrhaphy, 33 to <37 weeks gastroschisis,> 38 weeks thoracostomy with drain. The main complication found was sepsis 17 (42%) and death 16 (40%). It is worth noting that there was a higher occurrence of deaths in NBs with gestational age <28 weeks 8 (50%). Of the patients who underwent surgery, 20.5% died. CONCLUSIONS: The profile of patients undergoing surgery in the neonatal ICU was male NB, gestational age between 33 to <37 weeks, weighing> 2500g, born by cesarean section and without post-surgical complications. The rate of surgeries performed in the neonatal ICU was 14.9%. The main complication found was sepsis 42%. Post-surgical death rate was 20.5%.