Journal of Neonatal-Perinatal Medicine 10 (2017) 307–311 DOI:10.3233/NPM-16128 IOS Press 307 Original Research Preoperative metabolic acidosis in infants with gastroschisis W. El-Naggar a,* , A. Almudeer a , M. Vincer a and N.L. Yanchar b a Department of Pediatrics, Division of Neonatal Perinatal Medicine, Dalhousie University, Halifax, NS, Canada b Department of Surgery, Dalhousie University, Halifax, NS, Canada Received 2 October 2016 Revised 24 January 2017 Accepted 7 March 2017 Abstract. INTRODUCTION: There is little in literature regarding preoperative management of infants with gastroschisis. It is unclear if these infants develop metabolic acidosis as a consequence of prolonged intrauterine gut compromise or dehydration secondary to increased fluid loss. AIM: To assess the frequency of preoperative metabolic acidosis in infants with gastroschisis and investigate whether this acidosis reflects degree of gut compromise. METHODS: All infants with gastroschisis born between May 2005 and April 2013 in a single tertiary care center were reviewed. Metabolic acidosis was defined by the presence of pH <7.26 and serum bicarbonate <18.5 or base excess <–8.5 mmol/l. Infants with significant birth depression were excluded. Maternal and neonatal data were collected. Fre- quency of preoperative metabolic acidosis and its association with gastroschisis prognostic score (GPS), time to first and time to reach full feeds were investigated. RESULTS: Sixty infants were identified, 11 were excluded (birth depression/lack of preoperative blood gases). Median preoperative total fluid intake was 130 ml/kg/d. Nine infants (18%) had metabolic acidosis at a median age of 1.2 hours. No association was found between metabolic acidosis or serum lactate and GPS, age at first feed or age at full feeds. CONCLUSION: Preoperative metabolic acidosis was identified in a significant number of patients with gastroschisis despite high fluid intake. It does not appear to be associated with the degree of gut compromise. Using metabolic acidosis as an indication of dehydration in these patients needs more investigation. Keywords: Preoperative acidosis, gastroschisis, neonates Abbreviations NICU Neonatal intensive care unit HCO3 Bicarbonate BE Base excess * Address for correspondence: Walid El-Naggar, MD, FRCPC, Dalhousie University, IWK Health Centre, 5850/5980 Univer- sity Ave. PO Box 9700, Halifax, NS B3K 6R, Canada. Tel.: +1 902 470 7961; Fax: +1 902 470 6469; E-mail: walid.el- naggar@iwk.nshealth.ca. GPS Gastroschisis prognostic score PN Parenteral nutrition NEC Necrotizing enterocolitis 1. Introduction Gastroschisis is a life-threatening congenital mal- formation of the abdominal wall. It represents one of the most common surgical conditions that require 1934-5798/17/$35.00 © 2017 – IOS Press and the authors. All rights reserved