Necrotizing Enterocolitis

Bradshaw, Wanda T.

doi:10.1097/jpn.0b013e318196fefb

Cited by 17 publications

(5 citation statements)

References 12 publications

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“…Long-term parenteral nutrition, which is critical to the survival of surgically managed patients, can lead to hepatocellular damage, malabsorption of lipid-soluble vitamins, and mineral trace deficiencies. Secondary to NEC, patients may develop portal venous hypertension and hepatic failure 58 .…”

Section: Long-term Outcomes Associated With Necmentioning

confidence: 99%

Necrotizing Enterocolitis in the Premature Infant

Gregory

DeForge

Natale

et al. 2011

Advances in Neonatal Care

145

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Necrotizing enterocolitis (NEC) remains one of the most catastrophic comorbidities associated with prematurity. In spite of extensive research, the disease remains unsolved. The aims of this paper are to present the current state of the science on the pathogenesis of NEC, summarize the clinical presentation and severity staging of the disease, and highlight the nursing assessments required for early identification of NEC and ongoing care for infants diagnosed with this gastrointestinal disease. The distributions of systemic and intestinal clinical signs that are most sensitive to nursing assessment and associated with Bell Staging Criteria are presented. This descriptive data is representative of 117 cases of NEC diagnosed in low gestational age infants (<29 weeks gestation). The data highlights the clinical signs most commonly observed in infants with NEC, and thus, provides NICU nurses an evidence-based guide for assessment and care of infants with NEC.

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Section: Long-term Outcomes Associated With Necmentioning

confidence: 99%

Necrotizing Enterocolitis in the Premature Infant

Gregory

DeForge

Natale

et al. 2011

Advances in Neonatal Care

145

View full text Add to dashboard Cite

show abstract

“…Among common neonatal gastrointestinal urgencies, NEC is highly lifethreatening, with a high mortality if not treated in due course (2)(3)(4)(5)(6). So far, the etiology of NEC is still multifactorial (7,8). In pathological morphology, decreased perfusion and ischemia of the intestinal wall may cause disruption of the intestinal barrier, which enables bacterial infection and inflammation (9)(10)(11)(12)(13)(14)(15).…”

Section: ' Introductionmentioning

confidence: 99%

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Gao

Mao

et al. 2021

Clinics

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OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.

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“…In contrast to other intestinal diseases, such as an isolated perforation or congenital atresia, NEC is much more painful, both pre- and postoperatively, on account of the ongoing inflammatory and ischemic processes in the intestines as well as the related peritonitis [8,9]. There is consensus among clinicians that NEC-related pain must be assessed and treated, but how this should be done is unclear and this is usually left to the discretion of the treatment team [10,11,12]. To our knowledge, there are no guidelines for the assessment and management of NEC-related pain.…”

Section: Introductionmentioning

confidence: 99%

Infants Operated on for Necrotizing Enterocolitis: Towards Evidence-Based Pain Guidelines

et al. 2016

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Background: Necrotizing enterocolitis (NEC) is known as an extremely painful childhood condition. Objectives: The objective of this study was to explore pain management around NEC-related surgery in our neonatal intensive care unit (NICU) from a chart review of prospectively collected data on 60 operated NEC patients admitted between 2008 and 2013 with a median (IQR) gestational age of 28.3 (25.5-31.6) weeks. Methods: Pain medication data and pain scores (i.e. COMFORTneo and Numerical Rating Scale pain and distress scores) from 72 h before until 72 h after surgery were collected. Results: Preoperatively, 95% of the patients received morphine versus 100% postoperatively, with a median dosage of 10.0 (IQR 9.7-14.5) and 16.9 (IQR 10.1-20.0) μg/kg/h, respectively. Postoperatively, 28 patients (46.7%) received additional fentanyl intermittently and 14 (23.3%) received midazolam, which was part of palliative treatment for 6 patients (42.9%). In patients receiving pain medication, median COMFORTneo scores were 10 (IQR 10-11) preoperatively and 11 (10-12) postoperatively. The pain scores were comparable with those of other patients admitted to the NICU in the same time period. Conclusions: Continuous morphine of 10 μg/kg/h preoperatively, with an increase to 15 μg/kg/h postoperatively, seems to constitute a good starting dose for further individualized pain management guided by pain scores.

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Necrotizing Enterocolitis

Cited by 17 publications

References 12 publications

Necrotizing Enterocolitis in the Premature Infant

Necrotizing Enterocolitis in the Premature Infant

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

Infants Operated on for Necrotizing Enterocolitis: Towards Evidence-Based Pain Guidelines

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