Growth and feeding problems after repair of oesophageal atresia

Article Abstract:

Tracheo-esophageal fistula, the formation of an abnormal passage between the trachea and esophagus, and esophageal atresia, a birth-related failure of the esophagus to develop, occur in 1 out of every 5,000 births. Ninety percent of affected children survive after surgery, and those who survive into adulthood lead a normal life. However, affected individuals suffer feeding difficulties and repeated respiratory problems in early childhood. There is limited information about the growth and feeding problems in children after repair of esophageal atresia. Feeding problems may adversely affect the nutrition of these children, and influence their expected outcome. The prevalence of feeding problems in children after repair of esophageal atresia, the coping methods of their parents, and influence of these feeding problems on growth were assessed. One hundred and twenty-four families of children with esophageal atresia repaired by surgery, responded to a questionnaire. Children with repaired esophageal atresia were slower to feed, and had a greater frequency of refusing meals, coughing or choking during eating, and vomiting at meal times, as compared with 50 healthy children. Almost one third of patients showed delayed growth. Delayed growth was less common among children who had repair of esophageal fistulas than among children who had their abnormal esophagus replaced. Feeding problems resolved spontaneously and slowly, but persisted up to seven years of age in 50 percent of children. Feeding difficulties caused considerable worry among parents, who benefited from support provided by health care professionals with an interest in nutrition and feeding problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Development and progression, Children, Food and nutrition, Growth, Food habits, Esophagus, Esophageal atresia, Trachea, Fistula, Tracheoesophageal, Tracheoesophageal fistula

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Staff training: a key factor in reducing intravascular catheter sepsis

Article Abstract:

Central venous catheterization involves the insertion of a tube-like structure called a catheter into the superior vena cava, one of the major blood vessels, to permit intermittent or continuous monitoring of central venous pressure and to help obtain blood samples for analysis. This procedure also allows the administration of parenteral nutrition and hypertonic solutions (greater osmotic pressure than body fluids). Parenteral nutrition is when nutrient-containing fluids are administered directly into the circulation. However, catheter-related sepsis (infection of the blood) is a significant cause of death and disability. Control of infection involves periodic review of infection rates; proper catheter care helps to prevent catheter-related infection. The frequency of sepsis in central venous catheters used for parenteral nutrition was assessed by a nutritional care team in a children's hospital. Over a 12-month period, 26 out of 58 catheters were removed because of sepsis. This high rate of sepsis resulted in the modification of catheter care protocols and the implementation of an intensive staff training program. After these changes, only 9 of 107 catheters became infected. These findings demonstrate the importance of staff education in contributing to the control of central venous catheter sepsis; prevention of these infections is also cost effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Prevention, Complications and side effects, Nurses, Training, Parenteral feeding, Parenteral nutrition, Intravenous catheterization, Septicemia

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