Materiały źródłowe

• #1 Tracheal esophageal fistula and esophageal atresia | Children’s Wisconsin

  https://childrenswi.org/medical-care/fetal-concerns-center/conditions/infant-complications/tracheal-esophageal-fistula-and-esophageal-atresia

  A blind pouch of the esophagus with a fistula from the lower esophageal segment connecting with the trachea; this is the most common type and accounts for 86 percent of cases. […] A fistula is an abnormal connection and atresia means a blockage. An esophageal atresia is a blockage in the esophagus, which can occur with or without a fistula. […] TEF/EA is one of the most common gastrointestinal birth defects. It has a slightly higher incidence in males than females. The incidence rate of TEF/EA is approximately 1 in 4,000 live births. […] The affects that TEF/EA will have on your baby depends on the type of TEF. If there is a closure in the upper esophagus, the baby will not be able to swallow saliva or food. […] A fistula may increase the chances of respiratory problems. […] After birth, the inability to pass a tube into the stomach is cause to suspect TEF/EA.

• #2 Esophageal atresia/tracheoesophageal fistula: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/esophageal-atresia-tracheoesophageal-fistula/

  Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal development before birth of the tube that carries food from the mouth to the stomach (the esophagus). […] Almost 90 percent of babies born with esophageal atresia also have a tracheoesophageal fistula (TEF), in which the esophagus and the trachea are abnormally connected, allowing fluids from the esophagus to get into the airways and interfere with breathing. […] EA/TEF is a life-threatening condition; affected babies generally require surgery to correct the malformation in order to allow feeding and prevent lung damage from repeated exposure to esophageal fluids. […] EA/TEF occurs alone (isolated EA/TEF) in about 40 percent of affected individuals. […] EA/TEF occurs in 1 in 3,000 to 5,000 newborns.

• #3 Tracheoesophageal Fistula (TEF) – Congenital Abnormalities for Nursing RN

  https://www.picmonic.com/pathways/nursing/courses/standard/pediatric-nursing-372/congenital-abnormalities-1745/tracheoesophageal-fistula-tef_2213

  A tracheoesophageal fistula (TEF) occurs when there is an abnormal connection between the trachea and esophagus. This condition is often associated with esophageal atresia, a birth defect in which the esophagus ends in a blind pouch, rather than connecting to the stomach. […] Newborns suspected of having this condition are immediately made NPO to prevent aspiration and to ensure that the patients airway remains patent. […] Surgery is needed to correct the abnormality between the trachea and the esophagus. This is imminently needed in order for proper respiration and GI function. […] Because there is an abnormal connection between the trachea and esophagus, food or liquids from the esophagus can enter the patients airway. Aspiration of food or fluids into the lungs may lead to aspiration pneumonia.

• #4 Tracheoesophageal Fistula: Types, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23395-tracheoesophageal-fistula

  Tracheoesophageal fistula treatment involves corrective surgery. During this procedure, the connection between your babys esophagus and trachea is repaired. This may be done using traditional or minimally invasive techniques. […] If your baby has TEF, your healthcare provider will recommend surgery to address the problem. The extent of surgery depends on the type of TEF. If your baby has postoperative complications, your medical team will keep your baby in the hospital for a few days to monitor their progress. […] Left untreated, tracheoesophageal fistula is a life-threatening condition. Prompt care ensures that the abnormal connection between your babys esophagus and windpipe is repaired. This greatly reduces the risk of aspiration.

• #5 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Delivery should be planned at an obstetrical centre with ready access to a surgical unit. […] OA is linked with other clinical defects in more than 50% of babies, notably the VACTERL sequence (vertebral, anorectal, cardiac, tracheooesophageal, renal, and limb defects) and CHARGE associations (coloboma, heart defects, atresia choanae, retarded development, genital hypoplasia, ear abnormalities) with chromosomal anomalies that is, trisomy 18 and 21 and DiGeorge syndrome.

• #6 Oesophageal atresia with tracheo-oesophageal fistula in a preterm neonate in Limbe, Cameroon: case report & brief literature review | BMC Research Notes | Full Text

  https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-7-692

  Oesophageal atresia is a congenital anomaly in which there is interruption of the oesophageal lumen resulting in an upper and lower segment. […] A high index of suspicion for Oesophageal atresia/trachea-oesophageal fistula should prevail when faced with a neonate with the triad: respiratory distress during feeds, regurgitation and persistent frothy salivation. […] This illustrates the importance of detailed clinical examination in newborns. Thorough prenatal work-up is also important as the Oesophageal atresia may have been diagnosed earlier by ultrasound scan. Oesophageal atresia with proximal TOF is rare, and its rarer association with MAS together with absence of up to date diagnostic and management facilities, most likely led to delay in diagnosis in our case. A high index of suspicion for TOF should exist when faced with a newborn with the triad: respiratory distress especially during feeds, regurgitation and persistent frothy salivation.

• #7 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Tracheoesophageal Fistula (TEF) and Esophageal Atresia (EA) happen while a baby is growing during pregnancy. […] TEF and EA are not thought to be passed from parent to child (inherited). […] This can make a child cough or choke and lead to lung infections such as pneumonia. […] A baby with EA cannot feed by mouth, because there is no way for food and liquid to travel from their mouth to their stomach. […] If you would like an appointment, ask your primary care provider to refer you to our Tracheoesophageal Fistula and Esophageal Atresia Program. […] Symptoms of TEF/EA: Breathing problems and coughing or choking when your baby tries to swallow. The symptoms show up right after birth. This requires immediate attention with a specialty team. […] If doctors suspect your newborn has TEF/EA, they try to pass a tube from your babys nose or mouth into their stomach.

• #8 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Tracheo-oesophageal fistula (TOF) is a common congenital malformation involving a communication (fistula) between the trachea and oesophagus. It typically occurs with oesophageal atresia (OA), with the upper end of the oesophagus ending in a blind pouch. TOF/ OA is a relatively common congenital anomaly occurring in approximately 1:3000-4500 live births. […] Clinical presentation varies depending on the type of TOF and the presence (or absence) of oesophageal atresia. If OA is present (types A-D), infants are usually symptomatic immediately after birth with excessive secretions. This manifests as drooling, choking or coughing post-feeds, poor tolerance of feeds, and respiratory distress. […] The initial priorities include respiratory stabilization, decompressing the upper pouch to prevent aspiration, and planning surgical intervention. Fluid resuscitation should be commenced if the neonate is hemodynamically unstable, although ideally, you should avoid placing an endotracheal tube as this can cause gastric distension and subsequent perforation.

• #9 Tracheoesophageal Atresia Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/tracheoesophageal-atresia/

  Tracheoesophageal atresia (TEA) is a congenital anomaly involving the abnormal development of the trachea and esophagus during fetal development. As nursing professionals, understanding the intricacies of TEA and providing early detection and holistic care is essential in supporting infants and their families facing the challenges of this complex condition. […] Nursing care of an infant with tracheoesophageal atresia include: […] Assessment of an infant with tracheoesophageal atresia include: […] Based on the assessment data, the major nursing diagnoses are: […] The major nursing care planning goals for patients with Tracheoesophageal atresia are: […] Nursing interventions for a child with tracheoesophageal atresia are: […] Goals are met as evidenced by: […] Documentation in an infant with tracheoesophageal atresia include:

• #10 Nursing Care Plan For Esophageal Atresia – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-esophageal-atresia/

  The nursing diagnoses selected in the care plan prioritize addressing key issues, such as ineffective airway clearance, imbalanced nutrition, and the emotional distress experienced by the parents. These diagnoses guide the selection of appropriate interventions tailored to the neonates unique needs and circumstances. […] Immediate and postoperative care is central to this plan, including interventions such as maintaining patent airways, addressing nutritional needs, and preventing complications. In addition, we emphasize the importance of parent education and emotional support, as parents play a critical role in the care and advocacy for their newborns. […] The nursing assessment for neonates with esophageal atresia is a critical step in the early detection and management of this congenital condition. Timely identification of the condition and prompt intervention are essential for the infants well-being.

• #11 Oesophageal Atresia Intermittent oesophageal pouch suction for the neonate and infant

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intermittent_oesophageal_pouch_suction_for_the_neonate_-_infant_with_unrepaired_oesophageal_atresia_including_long-gap/

  Ongoing assessment for any sign of respiratory distress/compromise indicating the need for immediate and more frequent suction include: Apnoea, Desaturation (oxygen saturation below 90%), Bradycardia, Stridor, Use of accessory respiratory muscles, Increased respiratory rate or effort, Nasal flaring, Restlessness or circumoral (surrounding the mouth) cyanosis, Reduced or alter breath sounds, Blood-stained secretions. […] If any of the above signs are present, the infant should receive immediate oesophageal pouch suction. […] Signs of ongoing respiratory distress/compromise should be escalated to the neonatal registrar and surgical team to assess efficacy of current suction regime. […] The oesophageal pouch should be remeasured by the Oesophageal Atresia Nurse or the Surgical Registrar every 2 weeks (or sooner if required), to assess growth of the upper oesophageal pouch and to recalculate required length of pouch suction.

• #12 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Tracheoesophageal Fistula (TEF) and Esophageal Atresia (EA) happen while a baby is growing during pregnancy. […] TEF and EA are not thought to be passed from parent to child (inherited). […] This can make a child cough or choke and lead to lung infections such as pneumonia. […] A baby with EA cannot feed by mouth, because there is no way for food and liquid to travel from their mouth to their stomach. […] If you would like an appointment, ask your primary care provider to refer you to our Tracheoesophageal Fistula and Esophageal Atresia Program. […] Symptoms of TEF/EA: Breathing problems and coughing or choking when your baby tries to swallow. The symptoms show up right after birth. This requires immediate attention with a specialty team. […] If doctors suspect your newborn has TEF/EA, they try to pass a tube from your babys nose or mouth into their stomach.

• #13 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Delivery should be planned at an obstetrical centre with ready access to a surgical unit. […] OA is linked with other clinical defects in more than 50% of babies, notably the VACTERL sequence (vertebral, anorectal, cardiac, tracheooesophageal, renal, and limb defects) and CHARGE associations (coloboma, heart defects, atresia choanae, retarded development, genital hypoplasia, ear abnormalities) with chromosomal anomalies that is, trisomy 18 and 21 and DiGeorge syndrome.

• #14

  https://journals.lww.com/ajps/fulltext/2014/11040/management_of_associated_anomalies_of_oesophageal.1.aspx

  Tracheo-oesophageal fistula (TEF)/oesophageal atresia is one of the most common and serious congenital malformation. […] Despite progresses made in the field of early diagnosis, surgical techniques, ventilatory support and control of chest infections; morbidity and mortality still remains quite high and differs a lot from one to another centre particularly in the developing countries; as the availability and the level of neonatal care facilities are different. […] Associated anomalies play a significant role in dictating the outcome, timing of intervention and even the approach to management. […] The objectives of this review article is to outline the spectrum of associated anomalies, emphasise need of standardised system of documentation of anomalies, prognosis and management issues that would influence timing and approach of TEF repair.

• #15 Nursing Care Plan For Esophageal Atresia – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-esophageal-atresia/

  This comprehensive nursing assessment for neonates with esophageal atresia is critical for early detection and timely intervention. Esophageal atresia is a complex condition that requires a multidisciplinary approach, involving neonatology and pediatric surgery. Identifying the condition promptly and initiating appropriate care is essential for improving outcomes and minimizing complications for the newborn. […] These nursing diagnoses for esophageal atresia provide a foundation for developing a patient-centered care plan, addressing the immediate needs of the infant and their family. The selection of specific nursing diagnoses should be based on a comprehensive assessment and individualized to the infants unique condition and care goals. […] These nursing interventions aim to address the immediate and ongoing care needs of neonates with esophageal atresia and TEF. Collaboration with the healthcare team, parents, and ongoing assessment are crucial for optimizing patient outcomes and providing holistic care for the infant and their family.

• #16 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Tracheo-oesophageal fistula (TOF) is a common congenital malformation involving a communication (fistula) between the trachea and oesophagus. It typically occurs with oesophageal atresia (OA), with the upper end of the oesophagus ending in a blind pouch. TOF/ OA is a relatively common congenital anomaly occurring in approximately 1:3000-4500 live births. […] Clinical presentation varies depending on the type of TOF and the presence (or absence) of oesophageal atresia. If OA is present (types A-D), infants are usually symptomatic immediately after birth with excessive secretions. This manifests as drooling, choking or coughing post-feeds, poor tolerance of feeds, and respiratory distress. […] The initial priorities include respiratory stabilization, decompressing the upper pouch to prevent aspiration, and planning surgical intervention. Fluid resuscitation should be commenced if the neonate is hemodynamically unstable, although ideally, you should avoid placing an endotracheal tube as this can cause gastric distension and subsequent perforation.

• #17 Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) in children | CUH

  https://www.cuh.nhs.uk/patient-information/oesophageal-atresia-oa-and-tracheo-oesophageal-fistula-tof-in-children/

  Your baby has been diagnosed with having either oesophageal atresia (OA) and / or trachea-oesophageal fistula (TOF). This information leaflet is designed to guide you through surgery, caring for your baby once they are at home, and throughout childhood. […] Once a diagnosis is made, the doctors looking after your baby will make a referral to the paediatric surgery team who will come and meet you and your baby, and explain the next steps. […] Your baby will also have a special tube called a replogle tube passed through their nose or mouth into their oesophagus. This tube will allow the nurses caring for your baby to clear out the saliva that your baby cannot swallow. It is important that the Replogle tube is not pulled out, so your nurse might ask you to provide some mittens or socks that they can put over your babys hands to try and prevent this happening.

• #18 Oesophageal Atresia Intermittent oesophageal pouch suction for the neonate and infant

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intermittent_oesophageal_pouch_suction_for_the_neonate_-_infant_with_unrepaired_oesophageal_atresia_including_long-gap/

  It is the responsibility of the clinician caring for the infant with intermittent oesophageal pouch suction to ensure that the parents and caregivers understand the rationale for the intervention, as well as potential complications. […] The upper pouch must be kept clear of secretions by frequent oral suctioning to 1cm above the distal end of the oesophageal pouch – every 15 minutes or more frequently as required. […] Time between suctioning should not exceed 30 minutes due to the risk of aspiration of saliva.

• #19 Oesophageal Atresia Intermittent oesophageal pouch suction for the neonate and infant

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intermittent_oesophageal_pouch_suction_for_the_neonate_-_infant_with_unrepaired_oesophageal_atresia_including_long-gap/

  Intermittent oesophageal pouch suction is necessary in the management of neonates with unrepaired oesophageal atresia (OA) to avoid saliva pooling and refluxing into the lungs. This is required for all patients with an unrepaired OA who have not had a Replogle tube measured and inserted by the surgical team. […] To outline the principles of intermittent oesophageal pouch suction for infants with unrepaired oesophageal atresia in Newborn Intensive Care (NICU) at The Royal Childrens Hospital. […] As the neonate continues to produce saliva, it is essential to clear the upper oesophageal pouch every 15-30 minutes (or more frequently if necessary) to prevent aspiration. This continues until surgical repair of the oesophagus is performed or a functional Replogle tube is placed. […] The length of the oesophageal pouch should be measured with a size 10Fg suction catheter by the Surgical Registrar or Oesophageal Atresia Nurse.

• #20 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  Another method of oesophageal pouch suction is to position a Replogle tube 0.5 cm above the end of the oesophageal pouch and connect the Repogle tube to continuous low pressure suction (10 cm H2O) to aspirate saliva and prevent aspiration. […] Antibiotics are recommended if there is evidence of aspiration pneumonia or for presumed sepsis. […] The patient should be transported to a Level 6 surgical neonatal unit as soon as possible. In most cases early primary surgical repair is appropriate. […] A multidisciplinary approach, including surgeon, respiratory physician, physiotherapist, dietitian and speech therapist is needed.

• #21 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  Oesophageal atresia (OA) involves an interruption to the lumen of the oesophagus, with the oesophagus ending in a blind pouch. OA is usually associated with a tracheo-oesophageal fistula (TOF), which is an abnormal connection between the oesophagus and the trachea. […] Early diagnosis is important to minimise pulmonary complications. […] Regular, thorough suctioning of the upper oesophageal pouch is required prior to definitive surgical repair. […] Referral to PIPER and a tertiary neonatal surgical unit should be made as soon as possible. […] The neonate must be kept nil by mouth, commenced on intravenous fluids and nursed supine in a head up position (approximately 30-60 degrees). […] The upper pouch must be kept clear of secretions by frequent oral suctioning to 1 cm above the distal end of the oesophageal pouch (every 15 minutes or more frequently as required).

• #22 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  Esophageal atresia means your babys esophagus hasnt finished developing. It doesnt connect to their stomach, so they cant swallow or eat. Sometimes, it connects to their windpipe instead, which causes additional problems. Most babies have surgery to repair it soon after birth. […] Up to 90% of babies with esophageal atresia also have another birth defect called a tracheoesophageal fistula. This means their esophagus connects to their trachea their windpipe instead of their stomach. This can cause them to inhale or choke on what they swallow. […] Most of the time, surgery can fix the abnormality soon after your baby is born. Some babies may need to stay a little longer in the hospital, receiving nutrition and breathing support, before theyre ready for the operation. […] Babies with esophageal atresia will need medical assistance to eat until the abnormality can be fixed. Their healthcare providers will schedule surgery to correct it as soon as possible. In the meantime, theyll receive nutrition through a tube (enteral nutrition) or a vein (parenteral nutrition). This will continue during their surgery and recovery, until they can safely transition to mouth feeding.

• #23 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  Treatment for esophageal atresia includes stabilizing your babys breathing, providing safe nutrition and, ultimately, repairing the malformation through surgery. […] Immediate interventions for EA include: Suctioning of fluids from your babys esophagus. Installing a breathing tube to protect their airway. Installing a feeding tube or IV to deliver nutrition and fluids. IV antibiotics to prevent or treat pneumonia. […] Some babies may need to spend more time in the neonatal intensive care unit (NICU) before theyre ready for esophageal atresia surgery. This includes babies born prematurely, babies with multiple congenital malformations and babies with long-gap esophageal atresia (LGEA). […] Your babys healthcare team will determine when theyre ready for surgery. The goals of esophageal atresia surgery are to: Connect separate segments of the esophagus together (anastomosis). Close off any connections between your babys esophagus and airway.

• #24 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Feeding problems are a major source of concern in early childhood. […] Skilled nursing care and input from dieticians is invaluable. […] Respiratory problems are common in children with OA and TOF. […] Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] Adults with OA after successful primary anastomosis have been shown to enjoy an unimpaired quality of life. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #25 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Tracheo-oesophageal fistula (TOF) is a common congenital malformation involving a communication (fistula) between the trachea and oesophagus. It typically occurs with oesophageal atresia (OA), with the upper end of the oesophagus ending in a blind pouch. TOF/ OA is a relatively common congenital anomaly occurring in approximately 1:3000-4500 live births. […] Clinical presentation varies depending on the type of TOF and the presence (or absence) of oesophageal atresia. If OA is present (types A-D), infants are usually symptomatic immediately after birth with excessive secretions. This manifests as drooling, choking or coughing post-feeds, poor tolerance of feeds, and respiratory distress. […] The initial priorities include respiratory stabilization, decompressing the upper pouch to prevent aspiration, and planning surgical intervention. Fluid resuscitation should be commenced if the neonate is hemodynamically unstable, although ideally, you should avoid placing an endotracheal tube as this can cause gastric distension and subsequent perforation.

• #26 11.06 Tracheoesophageal Fistula and Esophageal Atresia – Obstetric and Newborn Care II

  https://brooksidepress.org/ob_newborn_care_2/?page_id=520

  a. Tracheoesophageal fistula is a developmental anomaly characterized by an abnormal connection between the trachea and the esophagus and usually accompanies esophageal atresia. […] b. Signs and symptoms vary according to location of fistula and atresia. […] d. Treatment. (1) Tracheoesophageal fistula and esophageal atresia requires surgical correction and are usually considered a surgical emergency. […] f. Nursing interventions. (1) Monitor respiratory status. (b) Perform pulmonary physiotherapy. (c) Suction as necessary. (2) Administer antibiotics and parenteral fluids as ordered. (3) Accurate IO. (4) Observe for signs of complications (that is, pneumothorax). (5) Maintain gastrostomy tube feedings. (6) Give the baby a pacifier to satisfy his sucking needs but only when he can safely handle secretions. (7) Offer the parents support and guidance and encourage bonding. (8) Positioning before and after surgery varies with the doctors philosophy and the childs anatomy. (a) Supine with his head low to facilitate drainage. (b) Head elevated to prevent aspiration.

• #27 Oesophageal atresia and tracheo-oesophageal fistula in neonates | Safer Care Victoria

  https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/oesophageal-atresia-and-tracheo-oesophageal-fistula-in-neonates

  Another method of oesophageal pouch suction is to position a Replogle tube 0.5 cm above the end of the oesophageal pouch and connect the Repogle tube to continuous low pressure suction (10 cm H2O) to aspirate saliva and prevent aspiration. […] Antibiotics are recommended if there is evidence of aspiration pneumonia or for presumed sepsis. […] The patient should be transported to a Level 6 surgical neonatal unit as soon as possible. In most cases early primary surgical repair is appropriate. […] A multidisciplinary approach, including surgeon, respiratory physician, physiotherapist, dietitian and speech therapist is needed.

• #28 11.06 Tracheoesophageal Fistula and Esophageal Atresia – Obstetric and Newborn Care II

  https://brooksidepress.org/ob_newborn_care_2/?page_id=520

  a. Tracheoesophageal fistula is a developmental anomaly characterized by an abnormal connection between the trachea and the esophagus and usually accompanies esophageal atresia. […] b. Signs and symptoms vary according to location of fistula and atresia. […] d. Treatment. (1) Tracheoesophageal fistula and esophageal atresia requires surgical correction and are usually considered a surgical emergency. […] f. Nursing interventions. (1) Monitor respiratory status. (b) Perform pulmonary physiotherapy. (c) Suction as necessary. (2) Administer antibiotics and parenteral fluids as ordered. (3) Accurate IO. (4) Observe for signs of complications (that is, pneumothorax). (5) Maintain gastrostomy tube feedings. (6) Give the baby a pacifier to satisfy his sucking needs but only when he can safely handle secretions. (7) Offer the parents support and guidance and encourage bonding. (8) Positioning before and after surgery varies with the doctors philosophy and the childs anatomy. (a) Supine with his head low to facilitate drainage. (b) Head elevated to prevent aspiration.

• #29 Oesophageal Atresia Intermittent oesophageal pouch suction for the neonate and infant

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intermittent_oesophageal_pouch_suction_for_the_neonate_-_infant_with_unrepaired_oesophageal_atresia_including_long-gap/

  It is the responsibility of the clinician caring for the infant with intermittent oesophageal pouch suction to ensure that the parents and caregivers understand the rationale for the intervention, as well as potential complications. […] The upper pouch must be kept clear of secretions by frequent oral suctioning to 1cm above the distal end of the oesophageal pouch – every 15 minutes or more frequently as required. […] Time between suctioning should not exceed 30 minutes due to the risk of aspiration of saliva.

• #30 Tracheo-oesophageal fistula and oesophageal atresia – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/tracheo-oesophageal-fistula-and-oesophageal-atresia/

  Post-operatively, infants are managed in the NICU for the optimisation of analgesia, respiratory support, close monitoring of fluid balance, establishing feeds, managing sepsis risk, and observing for any complications. […] Motility, digestive and nutritional problems are frequent issues in the long-term follow-up of these patients; thus, focusing on early detection and management is essential in preserving quality of life. Clinicians should routinely monitor for any symptoms or signs of GOR, dysphagia, aspiration or nutritional decline and investigate and manage thoroughly as indicated. Long-term endoscopic surveillance of these patients is also recommended.

• #31 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  Oesophageal atresia is a rare birth defect that affects a baby’s oesophagus (the tube through which food passes from the mouth to the stomach). […] These defects mean the baby won’t be able to swallow safely, if at all. […] They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth. […] An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose.

• #32 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  Oesophageal atresia is a rare birth defect that affects a baby’s oesophagus (the tube through which food passes from the mouth to the stomach). […] These defects mean the baby won’t be able to swallow safely, if at all. […] They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth. […] An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose.

• #33 11.06 Tracheoesophageal Fistula and Esophageal Atresia – Obstetric and Newborn Care II

  https://brooksidepress.org/ob_newborn_care_2/?page_id=520

  a. Tracheoesophageal fistula is a developmental anomaly characterized by an abnormal connection between the trachea and the esophagus and usually accompanies esophageal atresia. […] b. Signs and symptoms vary according to location of fistula and atresia. […] d. Treatment. (1) Tracheoesophageal fistula and esophageal atresia requires surgical correction and are usually considered a surgical emergency. […] f. Nursing interventions. (1) Monitor respiratory status. (b) Perform pulmonary physiotherapy. (c) Suction as necessary. (2) Administer antibiotics and parenteral fluids as ordered. (3) Accurate IO. (4) Observe for signs of complications (that is, pneumothorax). (5) Maintain gastrostomy tube feedings. (6) Give the baby a pacifier to satisfy his sucking needs but only when he can safely handle secretions. (7) Offer the parents support and guidance and encourage bonding. (8) Positioning before and after surgery varies with the doctors philosophy and the childs anatomy. (a) Supine with his head low to facilitate drainage. (b) Head elevated to prevent aspiration.

• #34 Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) in children | CUH

  https://www.cuh.nhs.uk/patient-information/oesophageal-atresia-oa-and-tracheo-oesophageal-fistula-tof-in-children/

  Your baby will be taken back to the neonatal unit after surgery, and will recover there. You will be able to see them as soon as they are settled back in their incubator. Your baby will initially require help with their breathing, and will be on a ventilator. They will also be given pain relief via a drip into their vein to allow them to rest and sleep. […] In order to allow the joins in your babys oesophagus and/or trachea to heal, it might be a while before your baby is allowed to take any milk orally. Initially your baby will be fed via one of the tubes in their vein (called parenteral nutrition, or PN). This will slowly be replaced by expressed breast milk or formula given through their nasogastric tube. […] Although you will not be able to stay next to your baby overnight, the nurses on the ward will encourage you to participate in as much of your babys care as you feel able to. […] Your baby will be followed up as an outpatient in clinic throughout their childhood. You will be able to call the nurse specialist team with any concerns you might have about your childs condition.

• #35 Tracheoesophageal Fistula & Esophageal Atresia | University of Utah Health

  https://healthcare.utah.edu/pediatric-surgery/conditions/tef-ea

  Several tubes may be used to help your baby recover after surgery. A chest tube helps drain fluid from the surgery site. A tube in your babys nose may connect to the stomach to release fluids and air while your baby recovers. A final tube will connect from your babys mouth to a breathing machine. We do not always use these tubes but sometimes they are helpful in recovery. If the tubes are put in place, it is very important that they are not dislodged in any way. […] Your babys medical team will perform a swallow study five days after surgery. If your babys doctor decides the surgical site is healing well, we will start removing the tubes and feeding your baby 57 days after surgery. […] Sometimes the repaired food tube leaks outside of the surgery site, which just means your baby will need to spend some more time in the hospital with the chest tube in to heal. Occasionally babies will need repeat surgery.

• #36 Oesophageal atresia and tracheo-oesophageal fistula | NHSGGC

  https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/oesophageal-atresia-and-tracheo-oesophageal-fistula/

  A Replogle tube is passed as soon as the diagnosis of trachea-oesophageal atresia is suspected / recognised. It is maintained within the pre-operative period to clear secretions continuously that would otherwise put the baby at risk of aspiration. […] The stable baby requires oral stimulation. […] The stable baby can be nursed with a pulse oximeter alone but has to be closely observed at all times. […] Ensure continuous suction is maintained during transport, using portable low pressure suction. […] Post operatively, the baby may have a Trans-Anastomotic nasogastric Tube (TAT) in place. This acts as a stent for the oesophageal anastomosis (and can be used for delivering gastric feeds when appropriate).

• #37 Esophageal Atresia | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/esophageal-atresia

  If your baby has a gastrostomy tube, the nurses will show you how to care for it and use it to administer feeding or decompress air from the stomach. […] If all is going well, a visit to our office at a specific time is not required. A visit to your child’s Primary Provider, at one to two weeks after the discharge, is recommended. […] Children with esophageal atresia and tracheoesophageal fistula may develop esophageal narrowing (stricture) at the site of repair. If this occurs, your child will have trouble swallowing liquids or solids. […] Call our office at 415-476-2538 for the following: Any concerns you have about your child’s recovery. […] Your nurses will instruct you how to care for the gastrostomy tube. At discharge, a replacement gastrostomy tube of the same size will be sent home with you.

• #38 Tracheoesophageal Fistula Repair – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/tracheoesophageal-fistula-repair/

  The restoration of esophageal continuity (esophageal atresia) and the repair of an abnormal connection between the trachea and the esophagus (tracheoesophageal fistula). […] Esophageal atresia, which may or may not be associated with fistula, may develop during the first 3 to 6 weeks of life. The most common fistula occurs at the upper segment of the esophagus, ending in a blind pouch with the lower segment of the esophagus connected by a fistula to the trachea. […] Prompt surgical intervention may prevent respiratory and eating difficulties. It may be necessary to perform a gastrostomy first, to decompress the air-distended stomach. […] When transferring a patient with a chest tube, keep the closed drainage system below body level. […] Use strict aseptic technique during the procedure. […] During the procedure, instruments used must be isolated in a basin.

• #39 Esophageal Atresia and Tracheoesophageal Fistula (EA/TEF) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/esophageal-atresia-and-tracheoesophageal-fistula-eatef

  After surgery for EA/TEF, your baby will return to the N/IICU. […] Your baby will not be able to eat by mouth until they have healed after surgery. Most babies first receive nutrition through the G-tube as they practice eating smaller amounts by mouth. […] Your care team will be here to support you and your family during your journey. […] Children with a history of EA and TEF are able to thrive after leaving the hospital with the help of a dedicated healthcare team.

• #40 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  Oesophageal atresia is a rare birth defect that affects a baby’s oesophagus (the tube through which food passes from the mouth to the stomach). […] These defects mean the baby won’t be able to swallow safely, if at all. […] They could also develop life-threatening problems such as choking and pneumonia if not treated quickly, so surgery will usually be carried out within a few days of birth. […] An operation to repair an oesophageal atresia and tracheo-oesophageal fistula is usually done soon after birth. […] Your baby will be taken to the neonatal intensive care unit, where they’re given a general anaesthetic. […] After surgery, your child will be kept in the intensive care unit and placed in an incubator. […] Your baby will be given nutrition intravenously at first, but you should be able to feed them after a few days using a feeding tube passed into their stomach through their nose.

• #41 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Babies with EA, with or without TEF, will need surgery soon after they are born. […] Our transport team is very experienced in safely moving fragile babies to Seattle Childrens from their birth hospital. […] We carefully assess your child to decide the best treatment for them. This includes any breathing support they need and the timing of surgery. […] After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] Our nurses and lactation specialists will do all that we can to support you in giving your baby breastmilk/chestmilk. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. Our feeding therapists help your child learn to feed by mouth. […] The hospital stay for babies with TEF and EA varies.

• #42 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Babies with EA, with or without TEF, will need surgery soon after they are born. […] Our transport team is very experienced in safely moving fragile babies to Seattle Childrens from their birth hospital. […] We carefully assess your child to decide the best treatment for them. This includes any breathing support they need and the timing of surgery. […] After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] Our nurses and lactation specialists will do all that we can to support you in giving your baby breastmilk/chestmilk. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. Our feeding therapists help your child learn to feed by mouth. […] The hospital stay for babies with TEF and EA varies.

• #43 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  After surgery, your baby will return to the NICU to recover. After several days, theyll have an imaging test to look inside their esophagus and see how its healed. […] While most children recover well and grow to adulthood, some may have lingering side effects from the esophageal atresia and the surgery to fix it. […] Common long-term side effects include: Tracheomalacia. This means that the cartilage in their trachea (windpipe) is weak, causing the windpipe to partially collapse. It can cause wheezing or noisy breathing, sleep apnea and shortness of breath. […] Your child may continue to have some esophageal dysmotility difficulties activating or coordinating their esophageal muscles. This can make eating difficult, especially when children transition to solid foods. […] Since children treated for EA are at a greater risk of chest infections, their healthcare team may recommend vaccines against COVID, flu, pneumonia and RSV.

• #44 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  After repair of oesophageal atresia in infancy, gastro-oesophageal reflux, oesophageal dysmotility and respiratory problems are common and significant oesophageal morbidity extends into adulthood. […] Management includes the use of antibiotics, physiotherapy and treatment of gastro-oesophageal reflux to minimise aspiration. Bronchodilators and inhaled steroids may be needed. […] Overall survival now exceeds 90% in dedicated centres.

• #45 Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) in children | CUH

  https://www.cuh.nhs.uk/patient-information/oesophageal-atresia-oa-and-tracheo-oesophageal-fistula-tof-in-children/

  Your baby will be taken back to the neonatal unit after surgery, and will recover there. You will be able to see them as soon as they are settled back in their incubator. Your baby will initially require help with their breathing, and will be on a ventilator. They will also be given pain relief via a drip into their vein to allow them to rest and sleep. […] In order to allow the joins in your babys oesophagus and/or trachea to heal, it might be a while before your baby is allowed to take any milk orally. Initially your baby will be fed via one of the tubes in their vein (called parenteral nutrition, or PN). This will slowly be replaced by expressed breast milk or formula given through their nasogastric tube. […] Although you will not be able to stay next to your baby overnight, the nurses on the ward will encourage you to participate in as much of your babys care as you feel able to. […] Your baby will be followed up as an outpatient in clinic throughout their childhood. You will be able to call the nurse specialist team with any concerns you might have about your childs condition.

• #46 Tracheoesophageal Fistula & Esophageal Atresia | University of Utah Health

  https://healthcare.utah.edu/pediatric-surgery/conditions/tef-ea

  If your baby is having a hard time swallowing, the food tube is too tight. The surgery team will need to open the area to stretch it, using a procedure called esophageal dilation. Some children will need repeated procedures. […] Some babies have tracheomalacia. This is the narrowing or collapse of the airway that can make it hard to breathe. Occasionally babies need surgery for this. […] Some babies get gastroesophageal reflux (GER) after surgery, which means some of the food and liquids in the stomach are pushed back up into the food tube. Medical staff will give your baby medicine to keep this from happening and will tell you how much medicine to give your baby when you go home. […] A few things need to happen before you can take your baby home. Your baby has to be able to take all feedings by mouth or with the help of a feeding tube, gain weight normally, and have a normal temperature while he or she is fully dressed in the crib.

• #47 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  You’ll be able to take your baby home once they’re taking food by mouth. […] Contact the hospital or your GP if your child is choking or coughing on their feeds, has any difficulty swallowing or is failing to gain weight. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #48 Esophageal Atresia | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/esophageal-atresia

  If your baby has a gastrostomy tube, the nurses will show you how to care for it and use it to administer feeding or decompress air from the stomach. […] If all is going well, a visit to our office at a specific time is not required. A visit to your child’s Primary Provider, at one to two weeks after the discharge, is recommended. […] Children with esophageal atresia and tracheoesophageal fistula may develop esophageal narrowing (stricture) at the site of repair. If this occurs, your child will have trouble swallowing liquids or solids. […] Call our office at 415-476-2538 for the following: Any concerns you have about your child’s recovery. […] Your nurses will instruct you how to care for the gastrostomy tube. At discharge, a replacement gastrostomy tube of the same size will be sent home with you.

• #49 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) are both congenital (present at birth) problems. […] Both conditions require repair with an operation under general anaesthetic lasting two to three hours. […] Once the repair has taken place, it can take some time for your child to completely recover. […] Suggestions contained in this information sheet are based on our extensive experience of looking after children with OA/TOF and promote safe feeding practices. […] For some children with OA/TOF, weaning and feeding can be straightforward, whereas for others difficulties can occur. […] There are a number of reasons why children with OA/TOF might develop feeding difficulties as described briefly below: Oesophageal incoordination/dysmotility, Oro-pharyngeal dysphagia, Stricture, Delayed repair, Gastro-oesophageal reflux.

• #50 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  A few days after the operation, when the doctors are happy that your child’s bowel is ready, they may suggest starting nasogastric (NG) feeding. […] Your child will continue with milk feeds until they are ready to start weaning (that is, introducing food). […] If appropriate you may be referred to a Speech and Language Therapist for advice and support. […] The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to make it easier to introduce foods in stages when someone has problems swallowing. […] Children with OA/TOF should aim to start weaning at stage 3. […] When the clinical team is happy for you to introduce more textured foods to your child, we suggest taking this in stages as follows: Smooth thick puree such as mashed potato or Weetabix with less milk, Well-mashed foods mashed banana or avocado work well but remember to mash them just before you feed them to your child, Small soft lumps in food for example, mashed potato with small pieces of soft cream cheese.

• #51 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  A few days after the operation, when the doctors are happy that your child’s bowel is ready, they may suggest starting nasogastric (NG) feeding. […] Your child will continue with milk feeds until they are ready to start weaning (that is, introducing food). […] If appropriate you may be referred to a Speech and Language Therapist for advice and support. […] The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to make it easier to introduce foods in stages when someone has problems swallowing. […] Children with OA/TOF should aim to start weaning at stage 3. […] When the clinical team is happy for you to introduce more textured foods to your child, we suggest taking this in stages as follows: Smooth thick puree such as mashed potato or Weetabix with less milk, Well-mashed foods mashed banana or avocado work well but remember to mash them just before you feed them to your child, Small soft lumps in food for example, mashed potato with small pieces of soft cream cheese.

• #52 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  A few days after the operation, when the doctors are happy that your child’s bowel is ready, they may suggest starting nasogastric (NG) feeding. […] Your child will continue with milk feeds until they are ready to start weaning (that is, introducing food). […] If appropriate you may be referred to a Speech and Language Therapist for advice and support. […] The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to make it easier to introduce foods in stages when someone has problems swallowing. […] Children with OA/TOF should aim to start weaning at stage 3. […] When the clinical team is happy for you to introduce more textured foods to your child, we suggest taking this in stages as follows: Smooth thick puree such as mashed potato or Weetabix with less milk, Well-mashed foods mashed banana or avocado work well but remember to mash them just before you feed them to your child, Small soft lumps in food for example, mashed potato with small pieces of soft cream cheese.

• #53 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  A few days after the operation, when the doctors are happy that your child’s bowel is ready, they may suggest starting nasogastric (NG) feeding. […] Your child will continue with milk feeds until they are ready to start weaning (that is, introducing food). […] If appropriate you may be referred to a Speech and Language Therapist for advice and support. […] The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to make it easier to introduce foods in stages when someone has problems swallowing. […] Children with OA/TOF should aim to start weaning at stage 3. […] When the clinical team is happy for you to introduce more textured foods to your child, we suggest taking this in stages as follows: Smooth thick puree such as mashed potato or Weetabix with less milk, Well-mashed foods mashed banana or avocado work well but remember to mash them just before you feed them to your child, Small soft lumps in food for example, mashed potato with small pieces of soft cream cheese.

• #54 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  Some foods are particularly problematic for children following OA/TOF repair as they tend to get stuck and cause blockages so you should avoid them: Doughy foods such as bread, doughnuts, pastries and thick crust pizza, Raw apples and raw vegetables, Citrus fruits, due to the pith (white stringy substance), Hot dogs, frankfurters and sausages, Lumps of meat, poultry or Quorn that need a lot of chewing or are stringy. […] If your child is coughing or choking or food seems to get stuck while eating and drinking, you should contact your clinical team for further assessment.

• #55 Oesophageal atresia.pptx

  https://www.slideshare.net/slideshow/oesophageal-atresiapptx/259179267

  Oesophageal atresia with tracheo-oesophageal fistula is a birth defect where the esophagus is not connected resulting in abnormal connections to the trachea. […] Post-operative nursing care focuses on assessing the airway and surgical site, ensuring proper nutrition, and monitoring for complications. […] Surgical repair and intensive nursing care are needed to address this congenital anomaly. […] Nursing Management Assessment Assess baby’s general condition during delivery Assess the respiratory status of patient. Monitoring oxygen saturation level Monitoring Arterial blood gas analysis. […] Nursing Interventions Provide oxygen, position baby slightly head up. Place suction equipment at the bedside, and suction as needed. Ensure proper nutrition by consulting with physician. Check placement of NG tube before feeding. Elevate the head of bed to 30 to 45 degrees while feeding the patient.

• #56 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Oesophageal atresiatracheoesophageal fistula (EA-TEF) is a common congenital digestive disease. Patients with EA-TEF face gastrointestinal, surgical, respiratory, otolaryngological, nutritional, psychological and quality of life issues in childhood, adolescence and adulthood. Although consensus guidelines exist for the management of gastrointestinal, nutritional, surgical and respiratory problems in childhood, a systematic approach to the care of these patients in adolescence, during transition to adulthood and in adulthood is currently lacking. The Transition Working Group of the International Network on Oesophageal Atresia (INoEA) was charged with the task of developing uniform evidence-based guidelines for the management of complications through the transition from adolescence into adulthood.

• #57 Oesophageal atresia and Tracheo-oesophageal Fistula

  https://www.rch.org.au/transition/brochures/Oesophageal_atresia_and_Tracheo-oesophageal_Fistula/

  People who have had surgery to repair OA/TOF generally have an excellent quality of life. However, oesophageal problems can develop at any time, sometimes without symptoms. […] Regardless of the type of OA/TOF you have, you will need life-long follow-up with a gastroenterologist (a doctor who specialises in the digestive system) for the ongoing monitoring of your oesophagus. […] You will need regular gastroscopies to monitor your oesophagus for any changes. […] After the initial surgery as a newborn, some people who have had an OA/TOF repair have ongoing or life-long problems. […] Anyone who has had an OA/TOF repair should maintain a healthy lifestyle into adulthood, including eating a healthy diet, exercising regularly and avoiding smoking or use of illicit drugs. […] Common problems include reflux, breathing and swallowing problems see your doctor if you experience any of these.

• #58 Oesophageal atresia and Tracheo-oesophageal Fistula

  https://www.rch.org.au/transition/brochures/Oesophageal_atresia_and_Tracheo-oesophageal_Fistula/

  People who have had surgery to repair OA/TOF generally have an excellent quality of life. However, oesophageal problems can develop at any time, sometimes without symptoms. […] Regardless of the type of OA/TOF you have, you will need life-long follow-up with a gastroenterologist (a doctor who specialises in the digestive system) for the ongoing monitoring of your oesophagus. […] You will need regular gastroscopies to monitor your oesophagus for any changes. […] After the initial surgery as a newborn, some people who have had an OA/TOF repair have ongoing or life-long problems. […] Anyone who has had an OA/TOF repair should maintain a healthy lifestyle into adulthood, including eating a healthy diet, exercising regularly and avoiding smoking or use of illicit drugs. […] Common problems include reflux, breathing and swallowing problems see your doctor if you experience any of these.

• #59 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Feeding problems are a major source of concern in early childhood. […] Skilled nursing care and input from dieticians is invaluable. […] Respiratory problems are common in children with OA and TOF. […] Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] Adults with OA after successful primary anastomosis have been shown to enjoy an unimpaired quality of life. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #60 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Patients with stable EA-TEF should be reviewed by a gastroenterologist at least every 2 years between 18 and 34 years of age and annually from the age of 35 years onwards. […] Endoscopic surveillance with biopsy samples and narrow-band imaging, where available, should be performed every 5 years between 18 and 28 years of age, every 3 years between 28 and 40 years of age, every 2 years between 40 and 50 years of age, and annually onwards. […] Long-term follow-up of patients with EA-TEF who underwent oesophageal substitution is of paramount importance. Gastrointestinal complications need to be assessed through serial symptom evaluation and regular endoscopies. […] The prevalence of malnutrition decreases with age in patients with EA-TEF. The incidence of underweight in adolescent and adult patients with EA-TEF is increased, often due to digestive symptoms.

• #61 After your child has had oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/after-your-child-has-had-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  Oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) are both congenital (present at birth) problems. […] Both conditions require repair in an operation under general anaesthetic lasting two to three hours. […] Once the repair has taken place, it can take some time for your child to completely recover. […] All babies at GOSH are given anti-reflux medication following OA/TOF repair. […] In addition, keeping babies upright after feeding can help. […] Children who have had OA/TOF repair can develop a distinctive cough, often referred to as a TOF cough. […] Children who have had an OA/TOF repair do not usually have more frequent infections than other children but are more likely to need treatment due to the problems coughing as described above. […] Narrowing can happen when scars or strictures develop following surgery to the oesophagus. […] Narrowing of the oesophagus is usually treated with a procedure called oesophageal dilatation, which is always carried out while your child is under a general anaesthetic. […] Children who have had OA/TOF repair will carry on coming back to GOSH regularly throughout childhood and adolescence.

• #62 Oesophageal atresia and Tracheo-oesophageal Fistula

  https://www.rch.org.au/transition/brochures/Oesophageal_atresia_and_Tracheo-oesophageal_Fistula/

  As a young person with oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) your ongoing care is important. […] The information in this booklet will help you learn about your condition, what surgery you had when you were a baby, and learn what problems may develop so you know when to see your doctor. […] Surgery performed to repair OA/TOF depends on the type of OA/TOF you had. You may have one or more operations, and most of your surgery would have happened when you were a baby. […] OA/TOF can only be repaired with surgery. The surgery is usually done in babies when they are only a few days old. […] If you have been treated in a paediatric hospital, you will usually go through a process called transition that helps to prepare you for your move to care in an adult setting.

• #63 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Dysphagia has a substantial effect on feeding and maintaining good nutritional status in adolescent and adult patients with EA-TEF. […] All adolescents with EA-TEF should be seen at the time of transition by a dietitian and deglutologist and routinely screened for nutritional deficiencies and swallowing difficulties, particularly those with concerns regarding their growth and dietary intake. […] We recommend that the psychological needs of adolescents and adults with EA-TEF and their parents be considered during transition with regard to the following. […] The transition of health care refers to the purposeful, planned shift from paediatric health care to receiving primary and speciality adult-oriented care that addresses the medical, psychosocial, educational and vocational needs of adolescents and young adults with chronic physical and medical conditions.

• #64 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Dysphagia has a substantial effect on feeding and maintaining good nutritional status in adolescent and adult patients with EA-TEF. […] All adolescents with EA-TEF should be seen at the time of transition by a dietitian and deglutologist and routinely screened for nutritional deficiencies and swallowing difficulties, particularly those with concerns regarding their growth and dietary intake. […] We recommend that the psychological needs of adolescents and adults with EA-TEF and their parents be considered during transition with regard to the following. […] The transition of health care refers to the purposeful, planned shift from paediatric health care to receiving primary and speciality adult-oriented care that addresses the medical, psychosocial, educational and vocational needs of adolescents and young adults with chronic physical and medical conditions.

• #65 Nursing Care Plan For Esophageal Atresia – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-esophageal-atresia/

  The nursing care plan developed for neonates with esophageal atresia and tracheoesophageal fistula (TEF) exemplifies the vital role of nursing in delivering specialized care for these infants and their families. Esophageal atresia is a complex congenital condition, and its management necessitates a multidisciplinary approach, involving neonatologists, pediatric surgeons, and dedicated nursing care. […] This care plan places a strong emphasis on early detection, prompt surgical intervention, and the provision of ongoing support for both the neonate and their family. It encompasses a holistic approach that addresses medical, emotional, and educational needs to provide the best possible care and outcomes for these infants.

• #66 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Dysphagia has a substantial effect on feeding and maintaining good nutritional status in adolescent and adult patients with EA-TEF. […] All adolescents with EA-TEF should be seen at the time of transition by a dietitian and deglutologist and routinely screened for nutritional deficiencies and swallowing difficulties, particularly those with concerns regarding their growth and dietary intake. […] We recommend that the psychological needs of adolescents and adults with EA-TEF and their parents be considered during transition with regard to the following. […] The transition of health care refers to the purposeful, planned shift from paediatric health care to receiving primary and speciality adult-oriented care that addresses the medical, psychosocial, educational and vocational needs of adolescents and young adults with chronic physical and medical conditions.

• #67 Welcome to Esophageal Atresia Care | Columbia Surgery

  https://columbiasurgery.org/esophageal-atresia-care

  The Researching Esophageal Atresia for Children’s Health (REACH) Clinic uses a minimally invasive surgical approach for EA repair, using three small incisions in the chest, whenever possible. After surgery, the multidisciplinary team provides long-term follow-up in order to ensure optimal care as children mature into adulthood. […] As children with EA/TEF grow up, they often face the challenge of finding adult medical specialists with the proper experience managing their condition. […] The collaborative format of the EA program also addresses an important need for patients and their families: the need to see multiple specialists for complicated, multi-system birth defects in the spectrum known as VACTERL (Vertebral anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula and/or Esophageal atresia, Renal Radial anomalies and Limb defects).

• #68 The International Network on Oesophageal Atresia (INoEA) consensus guidelines on the transition of patients with oesophageal atresia–tracheoesophageal fistula | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-023-00789-w

  Dysphagia has a substantial effect on feeding and maintaining good nutritional status in adolescent and adult patients with EA-TEF. […] All adolescents with EA-TEF should be seen at the time of transition by a dietitian and deglutologist and routinely screened for nutritional deficiencies and swallowing difficulties, particularly those with concerns regarding their growth and dietary intake. […] We recommend that the psychological needs of adolescents and adults with EA-TEF and their parents be considered during transition with regard to the following. […] The transition of health care refers to the purposeful, planned shift from paediatric health care to receiving primary and speciality adult-oriented care that addresses the medical, psychosocial, educational and vocational needs of adolescents and young adults with chronic physical and medical conditions.

• #69 Welcome to Esophageal Atresia Care | Columbia Surgery

  https://columbiasurgery.org/esophageal-atresia-care

  The Researching Esophageal Atresia for Children’s Health (REACH) Clinic uses a minimally invasive surgical approach for EA repair, using three small incisions in the chest, whenever possible. After surgery, the multidisciplinary team provides long-term follow-up in order to ensure optimal care as children mature into adulthood. […] As children with EA/TEF grow up, they often face the challenge of finding adult medical specialists with the proper experience managing their condition. […] The collaborative format of the EA program also addresses an important need for patients and their families: the need to see multiple specialists for complicated, multi-system birth defects in the spectrum known as VACTERL (Vertebral anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula and/or Esophageal atresia, Renal Radial anomalies and Limb defects).

• #70 Adulthood of patients after oesophageal atresia repair…

  https://ppch.pl/seo/article/01.3001.0014.8163/en

  Advancement in medicine allowed to improve survival rates and adulthood is reached more often in the population of OA patients. […] Despite being at a higher risk of gastroesophageal diseases such as GORD, BO and carcinoma, they do not often seek medical care. […] It is relevant that general surgeons possess knowledge on this condition and procedures restoring the continuity of the oesophagus. […] Therefore, it is important to know there is a variety of surgical management procedures, all the more some of them are not often used nowadays and fast access to the information can be constricted. […] Furthermore, patients with repaired OA need accurate follow-up in adulthood. […] On the contrary, they get used to symptoms experienced since childhood or develop adaptive behaviors. […] That is why it is so relevant to treat them with a deep understanding of this condition and alertness, also oncological.

• #71 Oesophageal Atresia Intermittent oesophageal pouch suction for the neonate and infant

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intermittent_oesophageal_pouch_suction_for_the_neonate_-_infant_with_unrepaired_oesophageal_atresia_including_long-gap/

  It is the responsibility of the clinician caring for the infant with intermittent oesophageal pouch suction to ensure that the parents and caregivers understand the rationale for the intervention, as well as potential complications. […] The upper pouch must be kept clear of secretions by frequent oral suctioning to 1cm above the distal end of the oesophageal pouch – every 15 minutes or more frequently as required. […] Time between suctioning should not exceed 30 minutes due to the risk of aspiration of saliva.

• #72 Nursing Care Plan For Tracheoesophageal Fistula – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-tracheoesophageal-fistula/

  Family-centered care, parental education, and psychosocial support play pivotal roles in fostering a positive care environment. Recognizing the potential stress and emotional impact on both infants and their families, healthcare professionals strive to provide not only medical interventions but also emotional support, education, and resources. […] As healthcare providers monitor the infants progress and adjust interventions accordingly, the ultimate goal is to promote optimal growth, development, and quality of life for infants with tracheoesophageal fistula. Through the collaborative efforts of the healthcare team and the active involvement of parents, the nursing care plan aims to navigate the complexities of TEF, offering compassionate and effective care to promote the best possible outcomes for these vulnerable patients.

• #73 Esophageal Atresia | UCSF Department of Surgery

  https://pedsurg.ucsf.edu/condition/esophageal-atresia

  If your baby has a gastrostomy tube, the nurses will show you how to care for it and use it to administer feeding or decompress air from the stomach. […] If all is going well, a visit to our office at a specific time is not required. A visit to your child’s Primary Provider, at one to two weeks after the discharge, is recommended. […] Children with esophageal atresia and tracheoesophageal fistula may develop esophageal narrowing (stricture) at the site of repair. If this occurs, your child will have trouble swallowing liquids or solids. […] Call our office at 415-476-2538 for the following: Any concerns you have about your child’s recovery. […] Your nurses will instruct you how to care for the gastrostomy tube. At discharge, a replacement gastrostomy tube of the same size will be sent home with you.

• #74 Oesophageal atresia and tracheo-oesophageal fistula

  https://www.nhs.uk/conditions/oesophageal-atresia/

  You’ll be able to take your baby home once they’re taking food by mouth. […] Contact the hospital or your GP if your child is choking or coughing on their feeds, has any difficulty swallowing or is failing to gain weight. […] Most children who have surgery will go on to have normal lives. […] Your child will be continuously monitored by specialists after their operation to pick up problems such as these and treat them early on.

• #75 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  Some foods are particularly problematic for children following OA/TOF repair as they tend to get stuck and cause blockages so you should avoid them: Doughy foods such as bread, doughnuts, pastries and thick crust pizza, Raw apples and raw vegetables, Citrus fruits, due to the pith (white stringy substance), Hot dogs, frankfurters and sausages, Lumps of meat, poultry or Quorn that need a lot of chewing or are stringy. […] If your child is coughing or choking or food seems to get stuck while eating and drinking, you should contact your clinical team for further assessment.

• #76 Nursing Care Plan For Tracheoesophageal Fistula – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-tracheoesophageal-fistula/

  Family-centered care, parental education, and psychosocial support play pivotal roles in fostering a positive care environment. Recognizing the potential stress and emotional impact on both infants and their families, healthcare professionals strive to provide not only medical interventions but also emotional support, education, and resources. […] As healthcare providers monitor the infants progress and adjust interventions accordingly, the ultimate goal is to promote optimal growth, development, and quality of life for infants with tracheoesophageal fistula. Through the collaborative efforts of the healthcare team and the active involvement of parents, the nursing care plan aims to navigate the complexities of TEF, offering compassionate and effective care to promote the best possible outcomes for these vulnerable patients.

• #77 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  Oesophageal atresia is a congenital anatomical malformation characterised by discontinuity of the oesophagus as a result of disruptions to foregut separation during embryological development. In the majority of cases, there is a fistula between the trachea and oesophagus, called a tracheo-oesophageal fistula (TOF). […] OA is usually surgically corrected in the first few days of life, and survival rates currently exceed 90% due to advancements in surgical techniques and neonatal intensive care. […] A multidisciplinary approach involving surgeons, physiotherapists, respiratory physicians, dieticians and speech therapists is best. […] Until surgery, supportive treatment is needed to allow hydration/feeding and to prevent aspiration. […] Immediate management involves a gastrostomy so that feeding is possible. Suctioning of the blind ending oesophagus is necessary to prevent aspiration and protect the airway. This should continue until surgery is performed. Prophylactic antibiotics may also be needed.

• #78 Welcome to Esophageal Atresia Care | Columbia Surgery

  https://columbiasurgery.org/esophageal-atresia-care

  The Researching Esophageal Atresia for Children’s Health (REACH) Clinic at Columbia/NYP Morgan Stanley Children’s Hospital was founded with the following goals in mind: Provide coordinated multidisciplinary care that addresses all facets of a child’s conditions. […] Help older patients transition to practitioners caring for adults who are well versed in the special needs associated with EA.

• #79 Esophageal Atresia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/tracheoesophageal-fistula-and-esophageal-atresia

  Esophageal atresia is a congenital disorder in which a baby’s esophagus does not form properly during pregnancy. […] Symptoms include white, frothy bubbles in the mouth, vomiting, and coughing/choking when feeding. […] Treatment includes surgery. […] At Yale Medicine, our maternal-fetal specialists are experts in treating rare conditions like esophageal atresia and TE fistula and many more problems that arise in utero. […] Our Yale Medicine surgeons are skilled at several treatments for esophageal atresia and TE fistula. […] A designated nurse coordinates all care and keeps families informed of every test result and procedure along the way. […] If the baby is stable, a procedure called a thoracotomy is performed in the first few days of life. An incision is made into the baby’s chest to gain access to the esophagus. The connection between the esophagus and the trachea is closed and the two ends of the esophagus are connected.

• #80 Tracheoesophageal Fistula and Esophageal Atresia – Seattle Children’s

  https://www.seattlechildrens.org/conditions/tef-and-ea/

  Babies with EA, with or without TEF, will need surgery soon after they are born. […] Our transport team is very experienced in safely moving fragile babies to Seattle Childrens from their birth hospital. […] We carefully assess your child to decide the best treatment for them. This includes any breathing support they need and the timing of surgery. […] After surgery for TEF/EA or EA, your baby will likely need a machine to help them breathe (ventilator). […] Our nurses and lactation specialists will do all that we can to support you in giving your baby breastmilk/chestmilk. […] Our nutritionists keep a careful watch on your baby to be sure they are growing well. Our feeding therapists help your child learn to feed by mouth. […] The hospital stay for babies with TEF and EA varies.

• #81 Feeding your child after oesophageal atresia and/or tracheo-oesophageal fistula repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/feeding-your-child-after-oesophageal-atresia-andor-tracheo-oesophageal-fistula-repair/

  A few days after the operation, when the doctors are happy that your child’s bowel is ready, they may suggest starting nasogastric (NG) feeding. […] Your child will continue with milk feeds until they are ready to start weaning (that is, introducing food). […] If appropriate you may be referred to a Speech and Language Therapist for advice and support. […] The International Dysphagia Diet Standardisation Initiative (IDDSI) was developed to make it easier to introduce foods in stages when someone has problems swallowing. […] Children with OA/TOF should aim to start weaning at stage 3. […] When the clinical team is happy for you to introduce more textured foods to your child, we suggest taking this in stages as follows: Smooth thick puree such as mashed potato or Weetabix with less milk, Well-mashed foods mashed banana or avocado work well but remember to mash them just before you feed them to your child, Small soft lumps in food for example, mashed potato with small pieces of soft cream cheese.

• #82 Oesophageal atresia and tracheo-oesophageal fistula (OA and TOF) – Royal Manchester Children’s Hospital

  https://mft.nhs.uk/rmch/services/manchester-centre-for-neonatal-surgery/conditions-we-treat-at-mcns/oesophageal-atresia-and-tracheo-oesophageal-fistula-oa-and-tof/

  Oesophageal atresia (OA) is where the food pipe (oesophagus) does not form correctly and is blocked. Babies with this condition are not able to swallow food or saliva. […] All babies with OA/TOF need surgery to protect the lungs and allow them to feed. This is successful in most cases, but many children will require further operations during their childhood. […] We have a joint surgical and respiratory clinic so children receive specialist care in one place, reducing the amount of appointments they have to attend and ensuring joined-up care. […] All babies with OA/TOF need urgent surgery to disconnect the TOF (fistula) between the windpipe and food pipe. […] During the operation it is often possible for the food pipe (oesophagus) to be repaired at the same time, so the baby can then feed. However, in some babies this is not possible and they might need further operations.

• #83 Esophageal Atresia and Tracheoesophageal Fistula | Texas Children’s

  https://www.texaschildrens.org/content/conditions/esophageal-atresia-and-tracheoesophageal-fistula

  Following surgery, the baby will remain in the hospital in the NICU until they are able to take food by mouth and are gaining weight, typically a few weeks. […] The Aerodigestive Program at Texas Children’s Hospital is one of the few of its kind in the southern United States. This expert team is dedicated to the comprehensive and multidisciplinary treatment of children with complex airway and digestive tract disorders, including EA/TEF. […] Long-term problems for babies with EA/TEF may include: Gastroesophageal reflux disease, or GERD, which causes acid to move up into the esophagus from the stomach, leading to a burning or painful feeling (heartburn). GERD can often be managed with medications. […] We care for your child’s needs at every stage of life. Our comprehensive approach starts with your first prenatal visit and continues throughout your child’s delivery, postnatal care, and beyond, thanks to one of the nation’s leading teams of fetal and pediatric specialists for the treatment of rare and complex birth defects of the airway and digestive tracts.

• #84 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Delivery should be planned at an obstetrical centre with ready access to a surgical unit. […] OA is linked with other clinical defects in more than 50% of babies, notably the VACTERL sequence (vertebral, anorectal, cardiac, tracheooesophageal, renal, and limb defects) and CHARGE associations (coloboma, heart defects, atresia choanae, retarded development, genital hypoplasia, ear abnormalities) with chromosomal anomalies that is, trisomy 18 and 21 and DiGeorge syndrome.

• #85 Oesophageal Atresia | Doctor

  https://patient.info/doctor/oesophageal-atresia

  After repair of oesophageal atresia in infancy, gastro-oesophageal reflux, oesophageal dysmotility and respiratory problems are common and significant oesophageal morbidity extends into adulthood. […] Management includes the use of antibiotics, physiotherapy and treatment of gastro-oesophageal reflux to minimise aspiration. Bronchodilators and inhaled steroids may be needed. […] Overall survival now exceeds 90% in dedicated centres.

• #86 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  Oesophageal atresia (OA) and tracheooesophageal fistula (TOF) has been a key domain of paediatric surgery since its early beginnings and continues to challenge specialists who care for these vulnerable children. […] With overall survival now exceeding 90% in dedicated centres, emphasis in the modern era has been on reducing morbidity and achieving improvements in the quality of life. […] The baby with OATOF classically presents with respiratory distress and feeding difficulties, choking, and frothing in the first few hours of life. […] Delivery should be planned at an obstetrical centre with ready access to a surgical unit. […] OA is linked with other clinical defects in more than 50% of babies, notably the VACTERL sequence (vertebral, anorectal, cardiac, tracheooesophageal, renal, and limb defects) and CHARGE associations (coloboma, heart defects, atresia choanae, retarded development, genital hypoplasia, ear abnormalities) with chromosomal anomalies that is, trisomy 18 and 21 and DiGeorge syndrome.

• #87 Esophageal Atresia and Tracheoesophageal Fistula | Children’s Mercy Kansas City

  https://www.childrensmercy.org/departments-and-clinics/fetal-health-center/understanding-esophageal-atresia-and-tracheoesophageal/

  Esophageal atresia and tracheoesophageal fistula are birth differences which affect the esophagus and/or trachea. […] These conditions are treated with surgery to connect the upper part of the esophagus to the stomach and to separate any connection between the esophagus and the windpipe. […] Until surgery is performed, your baby is not fed by mouth and a suction tube is kept in the upper esophagus to prevent saliva from being breathed into the lungs. […] After surgery, your baby will be fed by IV fluids through the vein. […] The length of stay in the NICU for an infant with this condition varies. […] Babies without any other significant birth differences have a survival rate of greater than 95 percent. […] Our team of specialists will provide ongoing care for your child to ensure that any problems are recognized early and treated.

• #88

  https://journals.lww.com/ajps/fulltext/2014/11040/management_of_associated_anomalies_of_oesophageal.1.aspx

  Major congenital anomalies are responsible for 55% mortality in OA-TEF patients. […] Complex cardiac anomalies account for most of deaths (35%). […] Various series document one or more than one additional congenital anomaly in 50-70% patients with OA-TEF. […] Routine echocardiography is recommended to detect and grade the severity of cardiovascular anomalies. […] Infants with major cardiac anomalies have 30% risk of mortality. […] Management of RAA is controversial. […] Infants with OA cardiac anomalies should be immediately put on prophylactic antibiotics to prevent infective endocarditis. […] Pure OA has higher incidence (30%) of anorectal malformations when compared to those with OA and TEF (1%). […] Oesophageal stenosis is a rare association more commonly found in patients with H type of TEF.

• #89 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Feeding problems are a major source of concern in early childhood. […] Skilled nursing care and input from dieticians is invaluable. […] Respiratory problems are common in children with OA and TOF. […] Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] Adults with OA after successful primary anastomosis have been shown to enjoy an unimpaired quality of life. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #90 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  Your healthcare team will care for them until surgery can repair the malformation and restore natural breathing and swallowing. After surgical repair, your child may have some continued difficulties related to swallowing, breathing and respiratory infections, especially in the first few years. But with ongoing care and attention, most children grow up to have relatively typical lives.

• #91 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Feeding problems are a major source of concern in early childhood. […] Skilled nursing care and input from dieticians is invaluable. […] Respiratory problems are common in children with OA and TOF. […] Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] Adults with OA after successful primary anastomosis have been shown to enjoy an unimpaired quality of life. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

• #92 Esophageal Atresia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21178-esophageal-atresia

  After surgery, your baby will return to the NICU to recover. After several days, theyll have an imaging test to look inside their esophagus and see how its healed. […] While most children recover well and grow to adulthood, some may have lingering side effects from the esophageal atresia and the surgery to fix it. […] Common long-term side effects include: Tracheomalacia. This means that the cartilage in their trachea (windpipe) is weak, causing the windpipe to partially collapse. It can cause wheezing or noisy breathing, sleep apnea and shortness of breath. […] Your child may continue to have some esophageal dysmotility difficulties activating or coordinating their esophageal muscles. This can make eating difficult, especially when children transition to solid foods. […] Since children treated for EA are at a greater risk of chest infections, their healthcare team may recommend vaccines against COVID, flu, pneumonia and RSV.

• #93 Oesophageal atresia and Tracheo-oesophageal Fistula

  https://www.rch.org.au/transition/brochures/Oesophageal_atresia_and_Tracheo-oesophageal_Fistula/

  People who have had surgery to repair OA/TOF generally have an excellent quality of life. However, oesophageal problems can develop at any time, sometimes without symptoms. […] Regardless of the type of OA/TOF you have, you will need life-long follow-up with a gastroenterologist (a doctor who specialises in the digestive system) for the ongoing monitoring of your oesophagus. […] You will need regular gastroscopies to monitor your oesophagus for any changes. […] After the initial surgery as a newborn, some people who have had an OA/TOF repair have ongoing or life-long problems. […] Anyone who has had an OA/TOF repair should maintain a healthy lifestyle into adulthood, including eating a healthy diet, exercising regularly and avoiding smoking or use of illicit drugs. […] Common problems include reflux, breathing and swallowing problems see your doctor if you experience any of these.

• #94 Oesophageal atresia and tracheo‐oesophageal fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2672849/

  The risk of recurrence in subsequent pregnancies of nonsyndromal OATOF is 1%. […] Immediate surgical management involves formation of a gastrostomy for feeding and regular suctioning of the blind upper pouch to protect the airway. […] Feeding problems are a major source of concern in early childhood. […] Skilled nursing care and input from dieticians is invaluable. […] Respiratory problems are common in children with OA and TOF. […] Management includes tailored use of antibiotics, physiotherapy, and optimal management of gastrooesophageal reflux to minimise the risk of recurrent aspiration. […] Gastrooesophageal reflux can significantly increase the risk of stricture formation, and fundoplication may ameliorate recalcitrant strictures. […] Gastrooesophageal reflux is recorded in almost 50% of children, although it is universally present to a degree in all patients. […] Adults with OA after successful primary anastomosis have been shown to enjoy an unimpaired quality of life. […] The challenge for the future is to further reduce morbidity to enable survivors and families lead normal productive lives in society.

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