Advances in necrotizing enterocolitis

Abstract

Significant results in terms of mortality and morbidity will be achieved through better understanding of necrotizing enterocolitis pathogenesis and clinical and surgical management in addition to the employment of preventative strategies.

Oxidative stress assessment in intestine of newborn rats submitted to hypoxia and reoxygenation with tadalafil

“…The necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in newborn 1 , its main risk factor is the prematurity, which associated to formula feeding, leading to bacterial invasion and triggering intestinal ischemia/ reperfusion phenomena (H/R) 2 . It is estimated that the disease affects between 5% and 15% of premature and about 7% of term infants admitted into neonatal intensive care units and that the mortality rate ranges between 18% and 45%, depending on the prematurity degree 1 .…”

“…The etiopathogeneses of NEC remains uncertain in such a way that effective measures in the treatment and prevention are still a challenge. Theories suggest that the lack of intestinal perfusion in newborns would cause a perturbation in the intestinal mucosa still immature jointly with a series of inflammatory reactions in cascade, with local invasion and bacterial proliferation, which would result in coagulation necrosis of affected areas 1 . As from these hypotheses, is assumed that studies directed to initial events of inflammatory cascade caused by H/R are more likely to provide favorable data in the search for effective prophylaxis.…”

Uso de fatores de crescimento epidérmico e estimulador de colônias de granulócitos na prevenção e tratamento da enterocolite necrosante no recém-nascido

“…Sua etiologia parece multifatorial, sendo considerados como principais fatores de risco a prematuridade, os episódios de diminuição da perfusão do intestino (isquemia transitória), a composição da dieta administrada ao RN e a velocidade de progressão da alimentação enteral, além da colonização bacteriana (4,5) . No início do quadro clínico, o RN apresenta distensão de alças intestinais, edema, aumento do volume de líquido peritonial e hematoquezia.…”

“…Esta morbidade responde por comprometimento da qualidade de vida do paciente e por elevado custo de assistência à saúde. Apesar dos progressos alcançados na terapia intensiva neonatal, a mortalidade pela ECN não apresentou redução nos últimos anos e situa-se entre 18 e 45%, dependendo do grau de prematuridade e da gravidade da doença (4,8) . Devido às elevadas taxas de morbidade e mortalidade, vêm sendo estudadas novas estratégias de prevenção e tratamento da ECN, focadas nos possíveis mecanismos fisiopatológicos, considerando que a imaturidade da motilidade, absorção e defesa gastrintestinais contribua para o alto risco e aumento da suscetibilidade das crianças prematuras à ECN.…”

Χορήγηση Αργινίνης Σε Πρόωρα Νεογνά Και Μέτρηση Της Καλπροτεκτίνης Των Κοπράνων Ως Δείκτη Φλεγμονής Του Εντέρου

“…Αυτό μπορεί να εξελιχθεί σε νέκρωση με διάτρηση του εντέρου[200]. Η υψηλή θνησιμότητα και νοσηρότητα από την ΝΕΚ δεν έχει βελτιωθεί σημαντικά κατά τα τελευταία 40 χρόνια[200,201]. Αν και έχει γίνει εκτεταμένη έρευνα ως προς την παθοφυσιολογία της ΝΕΚ, δεν έχει διευκρινιστεί πλήρως.συχνά υποαργινιναιμία[135], η οποία πιθανόν να προδιαθέτει αυτά τα νεογνά στην ανάπτυξη ΝΕΚ[112,202,203].…”