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1. Clinics (Sao Paulo). 2012;67(2):107-11.

Does administering albumin to postoperative gastroschisis patients improve
outcome?

Tannuri AC, Silva LM, Leal AJ, Moraes AC, Tannuri U.

Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

OBJECTIVES: Newborns who undergo surgery for gastroschisis correction may present
with oliguria, anasarca, prolonged postoperative ileus, and infection. New
postoperative therapeutic procedures were tested with the objective of improving
postoperative outcome.
PATIENTS AND METHODS: One hundred thirty-six newborns participated in one of two
phases. Newborns in the first phase received infusions of large volumes of
crystalloid solution and integral enteral formula, and newborns in the second
phase received crystalloid solutions in smaller volumes, with albumin solution
infusion when necessary and the late introduction of a semi-elemental diet. The
studied variables were serum sodium and albumin levels, the need for albumin
solution expansion, the occurrence of anasarca, the length of time on parenteral
nutrition, the length of time before initiating an enteral diet and reaching a
full enteral diet, orotracheal intubation time, length of hospitalization, and
survival rates.
RESULTS: Serum sodium levels were higher in newborns in the second phase. There
was a correlation between low serum sodium levels and orotracheal intubation
time; additionally, low serum albumin levels correlated with the length of time
before the initiation of an oral diet and the time until a full enteral diet was
reached. However, the discharge weights of newborns in the second phase were
higher than in the first phase. The other studied variables, including survival
rates (83.4% and 92.0%, respectively), were similar for both phases.
CONCLUSIONS: The administration of an albumin solution to newborns in the early
postoperative period following gastroschisis repair increased their low serum
sodium levels but did not improve the final outcome. The introduction of a
semi-elemental diet promoted an increase in body weight at the time of discharge.

PMCID: PMC3275118
PMID: 22358234 [PubMed - in process]