Current status of laboratory and imaging diagnosis of neonatal necrotizing enterocolitis

D’Angelo, Gabriella; Impellizzeri, Pietro; Montalto, Angela Simona; Russo, Tiziana; Salamone, Ignazio; Falsaperla, Raffaele; Corsello, Giovanni; Romeo, Carmelo; Gitto, Eloisa

doi:10.1186/s13052-018-0528-3

Cited by 40 publications

(34 citation statements)

References 50 publications

(59 reference statements)

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“…Care practices reported were chosen because they have been associated with neonatal outcomes and included antenatal steroids, cesarean delivery, surfactant therapy, and respiratory support. Morbidities included necrotizing enterocolitis (NEC), stage 1–3 10,11 ; early (≤72 hours) and late-onset (>72 hours) sepsis, defined by cultures positive for bacteria or fungi, and antibiotic therapy ≥5 days or intent to treat but death <5 days 12,13 ; intracranial hemorrhage (ICH); intraventricular hemorrhage(IVH); cystic periventricular leukomalacia (PVL); retinopathy of prematurity (ROP) among infants hospitalized at 28 days; and bronchopulmonary dysplasia (BPD), defined as oxygen use at 36 weeks postmenstrual age or at discharge/transfer if before 36 weeks in infants who survived to 36 weeks. ICH was based on the most severe cranial sonogram prior to hospital discharge, transfer, or death.…”

Section: Methodsmentioning

confidence: 99%

Care Practices, Morbidity and Mortality of Preterm Neonates in China, 2013–2014: a Retrospective study

Kong

Duan

et al. 2019

Sci Rep

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This retrospective cohort study aimed to investigate the prevalence, morbidity, mortality and the maternal/neonatal care of preterm neonates and the perinatal risk factors for mortality. We included data on 13,701 preterm neonates born in 15 hospitals for the period 2013–2014 in China. Results showed a prevalence of preterm neonates of 9.9%. Most infants at 24–27 weeks who survived more than 12 hours were mechanically ventilated (56.1%). Few infants born before 28 weeks received CPAP without first receiving mechanical ventilation (8.1%). Few preterm neonates received antenatal steroid(35.8% at 24–27 weeks, 57.9% at 28–31 weeks, 57.0% at 32–33 weeks and 32.7% at 34–36 weeks). Overall mortality was 1.9%. Most of the deaths at 24–27 weeks of gestation occurred within 12 hours after birth, accounting for 68.1%(32/47), and within 12–72 hours after birth at 28–36 weeks of gestation, accounting for 47.4%(99/209). Rates of survival to discharge increased from 68.2% at 24–27 weeks, 93.3% at 28–31 weeks, 99.2% at 32–33 weeks to 99.4% at 34–36 weeks. The smaller of the GA, there was a greater risk of morbidities due to prematurity. Preterm birth weight (OR = 0.407, 95% CI 0.346–0.478), antenatal steroid (OR = 0.680, 95% CI 0.493–0.938), and neonatal asphyxia (OR = 3.215, 95% CI 2.180–4.741) proved to significantly influence the odds of preterm neonatal death. Overall, our results support that most of the preterm neonates at 28–36 weeks of gestation survived without major morbidity. Rate of survival of GAs less than 28 weeks was still low. Maternal and infant care practices need to be improved in the very preterm births.

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Section: Methodsmentioning

confidence: 99%

Care Practices, Morbidity and Mortality of Preterm Neonates in China, 2013–2014: a Retrospective study

Kong

Duan

et al. 2019

Sci Rep

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“…Current understanding of the pathogenesis of NEC is that of disequilibrium between injury and repair of the intestinal mucosa, linked to various risk factors: genetic predisposition, impaired immunity, prematurity, enteral feeding, bacterial colonisation and intestinal ischaemia. 7 21 24 …”

Section: Pathological Correlation With Sonographymentioning

confidence: 99%

“…High frequency(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) linear transducer for detail of bowel wall.Low frequency (2-9 MHz) curved transducer for evaluation of abdominal fluid/localised collection, and so on.copyright. on October 30, 2020 by guest.…”

mentioning

confidence: 99%

Implementation of bowel ultrasound practice for the diagnosis and management of necrotising enterocolitis

Alexander

Chan

Opfer

et al. 2020

Arch Dis Child Fetal Neonatal Ed

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Necrotising enterocolitis (NEC) is a serious inflammatory bowel disease of prematurity with potentially devastating complications and remains a leading cause of morbidity and mortality among premature infants. In recent years, there has been accumulating data regarding benefits of using bowel ultrasound (BUS) in the diagnosis and management of NEC. Despite this, adoption of robust BUS programmes into clinical practice has been slow. As BUS is a relatively new technique, many barriers to implementation exist, namely lack of education and training for sonographers and radiologists, low case volume and unfamiliarity by clinicians regarding how to use the information provided. The aim of this manuscript is to provide a framework and a roadmap for units to implement BUS in day-to-day practice for NEC diagnosis and management.

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“…It is current clinical practice to diagnose NEC based on the clinical, radiological, and hematological findings constituting Bell's criteria, as per a recent review (49). However, Bell's criteria are not specific for NEC and cannot differentiate between NEC and non-NEC diseases (8,10).…”

Section: Clinical and Radiological Diagnosismentioning

confidence: 99%

Emerging Biomarkers for Prediction and Early Diagnosis of Necrotizing Enterocolitis in the Era of Metabolomics and Proteomics

et al. 2020

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Necrotizing Enterocolitis (NEC) is a catastrophic disease affecting predominantly premature infants and is characterized by high mortality and serious long-term consequences. Traditionally, diagnosis of NEC is based on clinical and radiological findings, which, however, are non-specific for NEC, thus confusing differential diagnosis of other conditions such as neonatal sepsis and spontaneous intestinal perforation. In addition, by the time clinical and radiological findings become apparent, NEC has already progressed to an advanced stage. During the last three decades, a lot of research has focused on the discovery of biomarkers, which could accurately predict and make an early diagnosis of NEC. Biomarkers used thus far in clinical practice include acute phase proteins, inflammation mediators, and molecules involved in the immune response. However, none has been proven accurate enough to predict and make an early diagnosis of NEC or discriminate clinical from surgical NEC or other non-NEC gastrointestinal diseases. Complexity of mechanisms involved in NEC pathogenesis, which remains largely poorly elucidated, could partly explain the unsatisfactory diagnostic performance of the existing NEC biomarkers. More recently applied technics can provide important insight into the pathophysiological mechanisms underlying NEC but can also aid the detection of potentially predictive, early diagnostic, and prognostic biomarkers. Progress in omics technology has allowed for the simultaneous measurement of a large number of proteins, metabolic products, lipids, and genes, using serum/plasma, urine, feces, tissues, and other biological specimens. This review is an update of current data on emerging NEC biomarkers detected using proteomics and metabolomics, further discussing limitations and future perspectives in prediction and early diagnosis of NEC.

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Current status of laboratory and imaging diagnosis of neonatal necrotizing enterocolitis

Cited by 40 publications

References 50 publications

Care Practices, Morbidity and Mortality of Preterm Neonates in China, 2013–2014: a Retrospective study

Care Practices, Morbidity and Mortality of Preterm Neonates in China, 2013–2014: a Retrospective study

Implementation of bowel ultrasound practice for the diagnosis and management of necrotising enterocolitis

Emerging Biomarkers for Prediction and Early Diagnosis of Necrotizing Enterocolitis in the Era of Metabolomics and Proteomics

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