Articles  |   November 2018
ACE Question
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Education / CPD / Articles
Articles   |   November 2018
ACE Question
ASA Monitor 11 2018, Vol.82, 44.
ASA Monitor 11 2018, Vol.82, 44.
Which of the following characteristics is most likely in a neonate with a gastroschisis rather than an omphalocele?
Omphalocele (Figure 1) and gastroschisis (Figure 2) represent two of the more common neonatal abdominal wall defects. The abdominal defect in gastroschisis is located in the periumbilical region, and the exposed abdominal contents lack a membranous covering, thereby potentially dramatically increasing evaporative and third-space fluid losses. Depending on the amount of abdominal contents that are exposed, intraoperative fluid requirements may exceed 10 mL/kg/h for third space losses alone. In contrast, the defect in omphalocele occurs within the umbilical cord, and the abdominal contents are commonly covered with some form of membranous sac. Although fluid requirements are increased in this condition, the presence of the membranous sac tends to reduce evaporative losses compared to a gastroschisis.
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