Clinical outcomes following implementation of a management bundle for esophageal atresia with distal tracheoesophageal fistula
Clinical outcomes following implementation of a management bundle for esophageal atresia with distal tracheoesophageal fistula
复制标题
DOI：
10.1016/j.jpedsurg.2020.09.049
复制
发表时间：
2021-01-13
影响因子：
2.4
通讯作者：
Lal, Dave R.
中科院分区：
文献类型：
--
作者：
Bence, Christina M.;Rymeski, Beth;Lal, Dave R.
Background/Purpose: This study evaluated compliance with a multi-institutional quality improvement management protocol for Type-C esophageal atresia with distal tracheoesophageal fistula (EA/TEF).Methods: Compliance and outcomes before and after implementation of a perioperative protocol bundle for infants undergoing Type-C EA/TEF repair were compared across 11 children's hospitals from 1/2016-1/2019. Bundle components included elimination of prosthetic material between tracheal and esophageal suture lines during repair, not leaving a transanastomotic tube at the conclusion of repair (NO-TUBE), obtaining an esophagram by postoperative-day-5, and discontinuing prophylactic antibiotics 24 h postoperatively.Results: One-hundred seventy patients were included, 40% pre-protocol and 60% post-protocol. Bundle compliance increased 2.5-fold pre- to post-protocol from 17.6% to44.1% (p
