Adherence to and Outcomes of a University-Consortium Gastroschisis Pathway
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In brief
In brief
Multi-institutional study evaluating a standardized gastroschisis care pathway implemented across a university consortium from 2015-2018. The pathway emphasized avoiding routine intubation, early closure, limited antibiotics/narcotics, and early feeding, resulting in significantly reduced ventilator days and length of stay compared to historical controls.
Written by the GCMD Library team from the article.
Background
Our multi-institutional university consortium implemented a gastroschisis pathway in 2015 to standardize and improve care by promoting avoidance of routine intubation and paralysis during silo placement, expeditious abdominal wall closure, discontinuation of antibiotics/narcotics within 48 h of closure, and early initiation/advancement of feeds.
Methods
Adherence to the gastroschisis pathway was prospectively monitored. Outcomes for the contemporary cohort (2015–2018) were compared with a historical cohort (2007–2012).
Results
Good adherence to the pathway was observed for 70 cases of inborn uncomplicated gastroschisis. The contemporary cohort had significantly lower median mechanical ventilator days (2 versus 5; p