Does Surgical Management Alter Outcome in Necrotizing Enterocolitis?

Carr, Benjamin; Gadepalli, Samir K.

doi:10.1016/j.clp.2018.09.008

Cited by 25 publications

(18 citation statements)

References 66 publications

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“…Whilst the principle of surgery for NEC is early intervention to reduce contamination and sepsis without subjecting infants with non-ischaemic bowel to unnecessary surgery [10,11], the lack of agreement in indications of surgery amongst surgeons [7] suggest that these principles may be implemented with variation. As such the decision making process around the time of surgery represents a potential opportunity to influence outcome [12], something that is desperately needed for infants with NEC [2].…”

Section: Discussionmentioning

confidence: 99%

Surgical necrotizing enterocolitis: Association between surgical indication, timing, and outcomes

Bethell

Knight

Hall

2021

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Surgical necrotizing enterocolitis: Association between surgical indication, timing, and outcomes

Bethell

Knight

Hall

2021

Journal of Pediatric Surgery

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“…However, clinical deterioration in the absence of pneumoperitoneum is also a common indication for surgical treatment (22). Surgical cases have high mortality according to the literature (23). This highest mortality probably reflects the fact that the patients who underwent surgery were sicker.…”

Section: Discussionmentioning

confidence: 99%

“…Current NEC treatments do not focus on reducing this inflammatory state directly. Surgery aims to remove gangrenous bowel segments, with the objective of reducing bacterial translocation, sepsis, and multiorgan dysfunction (23). Some authors have suggested that early laparotomy could improve the outcomes, but the optimal indications and timing for surgery in patients with NEC beyond perforation remain to be clarified (26).…”

Section: Discussionmentioning

confidence: 99%

Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study

et al. 2020

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Background: Data regarding the incidence and mortality of necrotizing enterocolitis trends are scarce in the literature. Recently, some preventive strategies have been confirmed (probiotics) or increased (breastfeeding rate). This study aims to describe the trends of necrotizing enterocolitis incidence, treatment, and mortality over the last decade in Spain. Methods:Multicenter cohort study with data from the Spanish Neonatal Network-SEN1500 database. The study period comprised from January 2005 to December 2017. Preterm infants <32 weeks of gestational age at birth without major congenital malformations were included for analysis. The main study outcomes were necrotizing enterocolitis incidence, co-morbidity (bronchopulmonary dysplasia, late-onset sepsis, cystic periventricular leukomalacia, retinopathy of prematurity, acute kidney injury), mortality, and surgical/non-surgical treatment.Results: Among the 25,821 included infants, NEC incidence was 8.8% during the whole study period and remained stable when comparing 4-year subperiods. However, more cases were surgically treated (from 48.

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“…Despite progress in neonatal intensive care and a greater understanding of the pathophysiology of this disease, the total mortality rate of NEC remains between 25% and 40% [2]. Furthermore, 30-50% of NEC cases require surgical treatment, with a mortality rate of 40-50% [3]. In addition, due to intestinal diseases and other complications of recovered infants, NEC patients may still require long-term hospitalization for cholestasis, short bowel syndrome, complete intestinal failure, and impaired neurodevelopment, which will further a ect their longterm survival, growth, and development [4].…”

Section: Introductionmentioning

confidence: 99%

β-Carotene Attenuates Apoptosis and Autophagy via PI3K/AKT/mTOR Signaling Pathway in Necrotizing Enterocolitis Model Cells IEC-6

Zhou

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Necrotizing enterocolitis (NEC) is a devastating disease affecting the gastrointestinal tract in the newborn period. In recent years, the role of apoptosis and autophagy in intestinal mucosal barrier dysfunction has come into prominence in research regarding the pathogenesis of NEC. β-Carotene is a well-known vitamin A precursor, and its content in breast milk is relatively high, especially in the colostrum. In the present study, we investigated the protective effect of β-carotene on necrotizing enterocolitis model cells IEC-6 induced by lipopolysaccharide (LPS). Methods. CCK-8 assay was performed to evaluate cell viability. The Annexin V-FITC/PI method was used to detect apoptosis. Western blotting was utilized to measure the expression levels of proteins. Immunofluorescence analysis was used to assess the autophagy of IEC-6 cells. Results. Our findings indicated that β-carotene inhibited the apoptosis of IEC-6 cells by downregulating cleaved caspase-3 levels and Bax levels and upregulating Bcl-2 levels, reducing cell autophagy via downregulating LC3II/I ratio and upregulating p62 levels. In addition, the expression of p-PI3K, p-AKT, and p-mTOR was upregulated after β-carotene treatment. Interestingly, these changes induced by β-carotene were partially reversed by rapamycin and voxtalisib. Conclusion. In conclusion, our findings indicated that β-carotene can attenuate apoptosis and autophagy of IEC-6 cells induced by LPS via activating the PI3K/AKT/mTOR signaling pathway. Therefore, β-carotene may be a promising drug used in the clinical treatment of NEC.

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Does Surgical Management Alter Outcome in Necrotizing Enterocolitis?

Cited by 25 publications

References 66 publications

Surgical necrotizing enterocolitis: Association between surgical indication, timing, and outcomes

Surgical necrotizing enterocolitis: Association between surgical indication, timing, and outcomes

Incidence, Treatment, and Outcome Trends of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Cohort Study

β-Carotene Attenuates Apoptosis and Autophagy via PI3K/AKT/mTOR Signaling Pathway in Necrotizing Enterocolitis Model Cells IEC-6

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