141. Vorgehen bei fulminanten Verlaufsformen der nekrotisierenden Enterocolitis

Hümmer, P.; Klein, Peter; Mang, Kristina

doi:10.1007/bf01274459

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Those without complete general demographic records were also excluded. ‘Fulminant NEC’ was defined as NEC with a rapid clinical progression, with 48 h or less from the onset of symptoms (such as emesis, abdominal distension or gross bloody stool) to death or severe disease requiring surgical management[4–7]. Finally, 352 newborns were enrolled in this study, among which 112 (31.8%) fulfilled the diagnosis criteria for fulminant NEC.…”

Section: Methodsmentioning

confidence: 99%

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Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years

et al. 2019

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The aim of this retrospective study was to explore the risk factors and clinical characteristics related to neonatal fulminant necrotizing enterocolitis (NEC). From 1 November 2007 to 31 October 2017, 352 neonates who were diagnosed with NEC (Bell stage ≥ΠB) and admitted to the Children’s Hospital of Chongqing Medical University were enrolled. Among these patients, 112 (31.82%) cases fulfilled the definition of fulminant NEC, and 62.5% (70/112) of fulminant cases presented a poor prognosis. All the survivors in the fulminant NEC group underwent surgery. Those in the fulminant NEC group were more likely to have the following clinical features: sepsis preceding NEC (P<0.001), abdominal distention (P<0.001), bowel sound disappearance (P = 0.001), leukopenia or neutropenia (P<0.001), C-reactive protein (CRP) <10 mg/L (P = 0.003), procalcitonin (PCT) < 2 μg/L (P<0.001), pH ≤7.2 (P<0.001), and radiographic evidence of pneumoperitoneum (P<0.001) or seroperitoneum on ultrasonography (P = 0.017). In conclusion, fulminant NEC is characterized by urgent onset and prompt deterioration, potentially resulting in death. The lack of unique characteristics makes it difficult to recognize by medical caregivers. Close observation, early detection and timely surgical intervention may improve the prognosis.

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Section: Methodsmentioning

confidence: 99%

“…Hummer P et al . reported 42 newborns with NEC (Bell stage ≥Ⅲ) in Germany between 1969–1985; 33.3% (14/42) of them suffering from fulminant courses[4]. Voss M et al .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years

et al. 2019

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“…Neonates were stratified into FNEC or NEC groups. FNEC, defined as NEC-totalis or death within 48 h diagnosis of NEC [4][5][6][7]. The diagnosis of neonatal shock was based on comprehensive judgment of blood pressure and assessment of regional and global perfusion, such as blood lactate concentrations, skin perfusion, mental status, and urine output [10].…”

Section: Study Subjectsmentioning

confidence: 99%

“…Additionally, a subset of these infants with FNEC have a particularly virulent form of NEC known as NEC-totalis. Definitions of NECtotalis vary in the literature but generally refer to patients with massive, near-total bowel ischemia and necrosis [4][5][6][7]. The lack of typical imaging findings and abdominal signs makes identification and diagnosis difficult.…”

Section: Introductionmentioning

confidence: 99%

Nomogram for predicting fulminant necrotizing enterocolitis

Zhang

et al. 2023

Pediatr Surg Int

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Background Fulminant necrotizing enterocolitis (FNEC) is the most serious subtype of NEC and has a high mortality rate and a high incidence of sequelae. Onset prediction can help in the establishment of a customized treatment strategy. This study aimed to develop and evaluate a predictive nomogram for FNEC. Methods We conducted a retrospective observation to study the clinical data of neonates diagnosed with NEC (Bell stage ≥ IIB). Neonates were divided into the FNEC and NEC groups. A multivariate logistic regression model was used to construct the nomogram model. The performance of the nomogram was assessed using area under the curve, calibration analysis, and decision curve analysis. Results A total of 206 neonate cases were included, among which 40 (19.4%) fulfilled the definition of FNEC. The identified predictors were assisted ventilation after NEC onset; shock at NEC onset; feeding volumes before NEC onset; neutrophil counts on the day of NEC onset; and neutrophil, lymphocyte, and monocyte counts on day 1 after NEC onset. The nomogram exhibited good discrimination, with an area under the receiver operating characteristic curve of 0.884 (95% CI 0.825–0.943). The predictive model was well calibrated. Decision curve analysis confirmed the clinical usefulness of this nomogram. Conclusion A nomogram with a potentially effective application was developed to facilitate the individualized prediction of FNEC, with the hope of providing further direction for the early diagnosis of FNEC and timing of intervention.

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Pathophysiologische Grundlagen und präoperative Vorbereitung

Segerer¹

1989

Anästhesie Bei Früh- Und Neugeborenen

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141. Vorgehen bei fulminanten Verlaufsformen der nekrotisierenden Enterocolitis

Cited by 4 publications

References 2 publications

Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years

Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years

Nomogram for predicting fulminant necrotizing enterocolitis

Pathophysiologische Grundlagen und präoperative Vorbereitung

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