Preventing Necrotizing Enterocolitis With Standardized Feeding Protocols

Gephart, Sheila M.; Hanson, Corrine

doi:10.1097/anc.0b013e31827ece0a

Cited by 45 publications

(23 citation statements)

References 49 publications

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“…Other studies have highlighted the importance of standardized feeding protocols LGA ¼ large-for-gestational age; NEC ¼ necrotizing enterocolitis; OR ¼ odds ratio; SGA ¼ small-for-gestational age; VLBW ¼ very-low-birth-weight. as strategies for achieving full enteral feeding and, therefore, preventing NEC (24).…”

Section: Discussionmentioning

confidence: 99%

Influence of Enteral Nutrition on Occurrences of Necrotizing Enterocolitis in Very‐Low‐Birth‐Weight Infants

Kimak

Antunes²,

Braga³

et al. 2015

J. pediatr. gastroenterol. nutr.

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Section: Discussionmentioning

confidence: 99%

Influence of Enteral Nutrition on Occurrences of Necrotizing Enterocolitis in Very‐Low‐Birth‐Weight Infants

Kimak

Antunes²,

Braga³

et al. 2015

J. pediatr. gastroenterol. nutr.

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“…However, over the past 2 decades several studies have suggested that using minimal enteral nutrition, which involves providing small quantities of feeding, initially usually less than 20 ml/kg/day for the first couple of days and then advancing to 20-35 ml/kg/day, appears to be relatively safe [61,62]. Several neonatal intensive care units have instituted nutritional and feeding guidelines [63,64], and these have been successfully utilized and actually have been shown to be efficacious in the prevention of NEC [65]. …”

Section: Preventative Measuresmentioning

confidence: 99%

Necrotizing Enterocolitis: The Mystery Goes On

Neu

2014

Neonatology

123

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Necrotizing enterocolitis (NEC) has largely been present in neonatal intensive care units for the past 60 years. NEC prevalence has corresponded with the continued development and sophistication of neonatal intensive care. Despite major efforts towards its eradication, NEC has persisted and appears to be increasing in some centers. The pathophysiology of this disease remains poorly understood. Several issues have hampered our quest to develop a better understanding of this disease. These include the fact that what we have historically termed ‘NEC' appears to be several different diseases. Animal models that are commonly used to study NEC pathophysiology and treatment do not directly reflect the most common form of the disease seen in human infants. The pathophysiology appears to be multifactorial, reflecting several different pathways to intestinal necrosis with different inciting factors. Spontaneous intestinal perforations, ischemic bowel disease secondary to cardiac anomalies as well as other entities that are clearly different from the most common form of NEC seen in preterm infants have been put into the same database. Here I describe some of the different forms of what has been called NEC and make some comments on its pathophysiology, where available studies suggest involvement of genetic factors, intestinal immaturity, hemodynamic instability, inflammation and a dysbiotic microbial ecology. Currently utilized approaches for the diagnosis of NEC are presented and innovative technologies for the development of diagnostic and predictive biomarkers are described. Predictions for future strategies are also discussed.

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“…32 The risk of distension in premature and sick infants needs to be addressed in the creation of "standardized feeding" protocols and practices, not just as a sign of potential intolerance but as a risk of BT and subsequent systemic infection. 33 In January 2013, the National Healthcare Safety Network introduced a modified definition for laboratoryconfirmed bloodstream infection (BSI). 34 The definition provides a mechanism to designate a BSI as related to mucosal barrier injury (MBI), but this pathogenesis is less well defined and understood in the neonatal population.…”

Section: Gastrointestinal Tract and Enteral Feedingmentioning

confidence: 99%

Infection Risk Reduction in the Intensive Care Nursery

Lefrak

2016

Journal of Perinatal &Amp; Neonatal Nursing

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Neonates are at high risk for developing an infection during their hospital stay in the neonatal intensive care unit. Increased risk occurs because of immaturity of the neonate's immune system, lower gestational age, severity of illness, surgical procedures, and instrumentation with life support devices such as vascular catheters. Neonates become colonized with bacteria prior to or at delivery and also during their hospital stay. They can then become infected with those bacteria if there is a breakdown in the primary defenses such as tissue injury due to skin breakdown, nasal erosion, or trauma to the respiratory tract. Neonates are also at high risk for bacterial translocation due to the altered permeability of the intestinal mucosa, loss of commensal flora, and bacterial overgrowth. The unit-based neonatal care team must implement global care delivery and safety practices, utilize published care guidelines, know and apply evidence-based practices from collaborative quality improvement efforts and other sources, and use auditing and monitoring practices that can identify risks and lead to better practice options to prevent infections. This article presents several aspects of global neonatal care delivery, including vascular access, which may reduce the risk of systemic infection during the hospitalization.

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Preventing Necrotizing Enterocolitis With Standardized Feeding Protocols

Cited by 45 publications

References 49 publications

Influence of Enteral Nutrition on Occurrences of Necrotizing Enterocolitis in Very‐Low‐Birth‐Weight Infants

Influence of Enteral Nutrition on Occurrences of Necrotizing Enterocolitis in Very‐Low‐Birth‐Weight Infants

Necrotizing Enterocolitis: The Mystery Goes On

Infection Risk Reduction in the Intensive Care Nursery

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