Avanços em enterocolite necrosante

Abstract

Suggested citation: de Oliveira ND, Miyoshi MH. Advances in necrotizing enterocolitis. J Pediatr (Rio J). 2005;81(1 Suppl):S16-S22. AbstractObjective: To evaluate recently reported findings on necrotizing enterocolitis, paying particular attention to pathogenesis, management and preventative strategies.Data sources: The articles covered in this report consist of randomized and quasi-randomized trials, case control studies, meta-analyses and reviews published recently. Certain other articles were also included because of their utmost importance to the subject.Results: Necrotizing enterocolitis remains a major cause of morbidity and mortality in preterm infants. Those who are born with intra-uterine-growth retardation are at a several-fold increased risk. Possible pathophysiologic processes beginning in utero and continuing after birth are discussed in this review. Other factors involved in the process are related to the role of arginine and the production of intestinal nitric oxide and the action of epidermal growth factor in the regulation of cell regeneration. Perforated necrotizing enterocolitis is a complex surgical problem; definitive evidence-based guidelines for the best approach are yet to be determined. After surgery, although residual small bowel length and the presence of the ileo-cecal valve remain important predictors of duration of parenteral nutrition in infants, other factors, such as the early use of breast milk or amino acid-based formula, may also play a role in intestinal re-adaptation. Prevention strategies have centered on feeding practices and emerging experiments such as amino acid supplementation, are also discussed. Conclusion: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.J Pediatr (Rio J). 2005;81(1 Suppl):S16-S22: Necrotizing enterocolitis, prematurity, short bowel syndrome.

Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis

“…2 Sua incidência é bastante variável, afetando 2-22% dos recém-nascidos de muito baixo peso (< 1.500 g). 2,3 A ocorrência da ECN é inversamente proporcional à idade gestacional do nascimento, devido à imaturidade fisiológi-ca intestinal dos prematuros. Desta forma, os probióticos, um grupo de organismos capaz de melhorar este quadro, vêm sendo estudado a fim de combater a progressão da doença.…”

Clinical and epidemiological characterization of newborns with necrotizing enterocolitis

“…This may be justified by the fact that parenteral nutrition is often associated with the treatment of the disease, as it is necessary to suspend the enteral diet for a few days according to clinical severity 15 . Thus, parenteral nutrition provides the nutritional requirements for the recovery of impaired bowel function 16 .…”

Sí­ndrome do intestino curto

“…De acordo com a Sociedade Brasileira de Pediatria [4] cerca de 7% dos Recémnascidos (RN) a termo possuem ECN, que consiste em uma necrose, desconhecendo-se a causa, em um segmento do intestino, normalmente íleo terminal, e todo intestino grosso, que após ser tratada pode apresentar como consequência a SIC.…”