Quick Literature Updates Episode 16
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Key Takeaways
- Critical Airway Response Team algorithm significantly reduced time from chest x-ray to OR for esophageal button battery removal.
- Exclusive breast milk vs formula feeding showed no outcome differences in uncomplicated gastroschisis (time to feeds, NEC rates, LOS).
- Cryoablation experience in Nuss procedures: fourth-quarter patients discharged 1.3 days earlier and used 74% less opioids than first quarter.
- Standardized protocols for pediatric surgical emergencies like button batteries can expedite critical interventions.
- Institutional experience with cryoanalgesia techniques improves both recovery time and opioid reduction in pectus excavatum repair.
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Transcript
Hello Pediatric Surgery family. I'm M. Ghodi from Cincinnati Children's Hospital Medical Center. And today our team is gonna deliver the articles that you should know about. We have three papers today. All of them are from the Journal of Pediatric Surgery. We don't have much time, so let's start. Our first paper titled "Utilizing a Critical Airway Response Team Expedites Esophageal Button Battery Removal" by Brent et al. This paper is summarized by Elandon Cisco. She's one of the previous research fellows at Cincinnati Children's. In 2019, the team at Connecticut Children's Medical Center implemented this algorithm for managing esophageal button batteries. It includes activating the Critical Airway Response Team. They took a look at patients presenting with esophageal button batteries before algorithm implementation between 2015 and 2019, and patients presenting after algorithm implementation between 2019 and 2022. They found that there was a significant reduction in the time it took from getting the chest x-ray to getting to the OR for button battery removal after they implemented the new algorithm. Based on this data, it looks like the implementation of this algorithm helped the kids get the care they needed faster. What does your institution do for esophageal button batteries? Let's hear the second paper. "Association of Exclusive Breast Milk Intake and Outcomes in Infants with Uncomplicated Gastroschisis, a National Cohort Study" by Hodson et al. And this paper is summarized by Alan Zelper. He's a research fellow at Children's National and collaborates with us to produce these article reviews. The team at McMaster University performed a retrospective review looking at infants born between 2014 and 2022 with uncomplicated gastroschisis. They found that the infants with exclusive breast milk intake and the ones with supplemental or exclusive formula intake had similar outcomes. With no significant differences between the groups in time to reach full andl feeds, duration of parenteral nutrition, rates of necrotizing enterocolitis, and length of stay in the hospital. So it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis. Now, moving to the last paper of today, "Cryoablation in 350 Nuss Procedures, Evolution of Hospital Length of Stay and Opioid Use" by Li et al. This one is summarized by Cecily Hanna. She is also one of the previous research fellows at Cincinnati Children's Hospital. This is a retrospective single institution study done in Phoenix from 2017 to 2021. And their aim was to compare patients that underwent non-procedure with cryoanalgesia in the first quarter of their experience with the fourth quarter of their experience. And what did they find? They had 350 patients that underwent procedure with cryoanalgesia. And what they found is that patients in the last quarter were discharged 1.3 days earlier than patients in the first quarter, and also require 74% less opioids. So, it seems that experience really plays a role talking about cryoanalgesia. Thank you for listening. Please check the link in the description below to read each paper. We hope you liked this episode. Please follow Stay Current MD on social media, give us a rating, and subscribe to YouTube channel. And don't forget to download the Stay Current app on the App Store or Play Store for tons of content. Global Cast MD along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe.