Associations of perioperative characteristics with motor function in preschool children born with esophageal atresia

Camille E. van Hoorn*, Monique H.M. van der Cammen-van Zijp, Robert Jan Stolker, Joost van Rosmalen, Rene M.H. Wijnen, Jurgen C. de Graaff

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)

Abstract

Background: Children born with esophageal atresia experience long-term neurodevelopmental deficits, with unknown origin. Aims: To find associations between perioperative variables during primary esophageal atresia repair and motor function at age 5 years. Methods: This ambidirectional cohort study included children born with esophageal atresia who consecutively had been operated on in the Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, from January 2007 through June 2013. The perioperative data of this cohort were collected retrospectively; the motor function data prospectively. Results: After exclusion of patients with syndromal congenital diseases (n = 8) and lost to follow-up (n = 10), the data of 53 children were included. The mean (SD) total motor function impairment z-score at 5 years of age was −0.66 (0.99), significantly below normal (p <.001). In multivariable linear regression analysis, number of postoperative days endotracheal intubation (B = −0.211, 95% CI: −0.389 to −0.033, p =.021) was negatively associated with motor outcome, whereas high blood pressure (B = 0.022, 95% CI 0.001 to 0.042, p =.038) was positively associated. Preoperative nasal oxygen supplementation versus room air (B = 0.706, 95% CI: 0.132 to 1.280, p =.016) was positively associated with motor outcome, which we cannot explain. Conclusions: Motor function in 5-year-old esophageal atresia patients was impaired and negatively associated with the number of postoperative days of endotracheal intubation and positively associated with high blood pressure. Prospective studies with critical perioperative monitoring and monitoring during stay at the intensive care unit are recommended.

Original languageEnglish
Pages (from-to)854-862
Number of pages9
JournalPaediatric Anaesthesia
Volume31
Issue number8
DOIs
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
This research was carried out with first-line departmental funding.What is already known about the topic? Children born with esophageal atresia suffer long-term neurodevelopmental impairments, of unknown origin. What new information does this study add? Motor function of children born with esophageal atresia is impaired at 5?years. Motor outcome of children born with esophageal atresia is negatively associated with the number of postoperative days of endotracheal intubation. Motor function in these children is positively associated with a high blood pressure. Children born with esophageal atresia suffer long-term neurodevelopmental impairments, of unknown origin. Motor function of children born with esophageal atresia is impaired at 5?years. Motor outcome of children born with esophageal atresia is negatively associated with the number of postoperative days of endotracheal intubation. Motor function in these children is positively associated with a high blood pressure. We thank Ko Hagoort of the department of pediatric surgery at the Erasmus MC-Sophia Children's Hospital University Medical Center, Rotterdam, The Netherlands for editorial assistance.

Publisher Copyright:
© 2021 The Authors. Pediatric Anesthesia published by John Wiley & Sons Ltd.

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