Laboratory parameters predictive of developing necrotizing enterocolitis in infants born before 33 weeks of gestation

Hällström, Minna; Koivisto, Anna‐Maija; Janas, M; Tammela, Outi

doi:10.1016/j.jpedsurg.2005.12.034

Cited by 56 publications

(43 citation statements)

References 21 publications

(29 reference statements)

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“…Although some serum markers, such as CRP and IL-6, have been studied, all of them showed lack of specificity. There are also conflicting data about the use of these inflammatory mediators in the diagnosis and follow-up of NEC (Pourcyrous et al 2005;Harris et al 2005;Hallstrom et al 2006;Young et al 2009). …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, its delayed occurrence after birth, its rapid onset, highly fulminant nature, and progression to death, as well as its severe morbidity, require identification of prospective new biomarkers specific for high NEC risk (Young et al 2009). Some studies have suggested the efficacy of several inflammatory mediators such as C-reactive protein (CRP), interleukin-6 (IL-6) and serum amyloid A (SAA) measurements in the diagnosis of NEC (Pourcyrous et al 2005;Hallstrom et al 2006;Markel et al 2006;Evennett et al 2009;Cetinkaya et al 2010). These all have difficulties that limit their use.…”

mentioning

confidence: 99%

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C5a, A Complement Activation Product, Is a Useful Marker in Predicting the Severity of Necrotizing Enterocolitis

Tayman

Tonbul

Kahveci³

et al. 2011

Tohoku J. Exp. Med.

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Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency, predominantly affecting low-birth weight, premature infants. Early clinical signs of NEC are nonspecific and the laboratory findings are not fully reliable. Its severe morbidities and rapid progression require the application of new biomarkers for early diagnosis and intervention. The complement activation product, C5a (anaphylatoxin) has been reported to be a contributing factor leading to mesenteric ischemia/reperfusion injury which is a predisposing factor in the pathogenesis of NEC. Therefore, our aim was to evaluate the efficacy of serial C5a measurements in the diagnosis and follow-up of NEC. Preterm infants, whose gestational age and weight matched each other, were grouped as controls (n = 23) and NEC (n = 22). Serum levels of C5a, serum amyloid-A (SAA), C-reactive protein (CRP), and interleukin-6 (IL-6) levels were measured on the third day of life for the control group and on the day of diagnosis (1 st day), 3 rd and 7 th days of the NEC group. C5a, SSA, CRP, and IL-6 levels were significantly higher in the NEC patients compared to the control group (P < 0.05) in the follow-up. Additionally, serum levels of C5a were found to be more accurate than the other parameters for the prediction of death and requirement for surgery at the time of diagnosis (P < 0.05). In conclusion, C5a may be useful as a new marker for both diagnosis and follow-up of infants with NEC in combination with clinical and radiographical findings.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

C5a, A Complement Activation Product, Is a Useful Marker in Predicting the Severity of Necrotizing Enterocolitis

Tayman

Tonbul

Kahveci³

et al. 2011

Tohoku J. Exp. Med.

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“…Also, little information exists about the relation between I-FABP and other commonly used blood parameters, e.g. white blood cell count (WBC), platelet count and C-reactive protein (CRP) [11]. …”

Section: Introductionmentioning

confidence: 99%

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Schurink¹,

Scholten²,

Kooi

et al. 2014

Neonatology

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Background: Intestinal fatty acid-binding protein (I-FABP) is a promising marker for necrotizing enterocolitis (NEC). It can be measured in plasma (I-FABPp) and urine (I-FABPu). Data on the best way to measure I-FABP (in plasma or urine) and the necessity of simultaneous measurement of the urinary creatinine concentration to correct for physiological variations in urine concentration are not available. This holds also true for the reciprocal relation between I-FABPp, I-FABPu and other more conventional laboratory parameters. Objectives: To evaluate the above-mentioned correlations of I-FABP measurements in neonates with suspected NEC. Methods: All neonates with suspected NEC were prospectively included. I-FABPp and I-FABPu were analyzed at regular intervals during the first 24 h after onset of symptoms. Correlation and agreement were assessed between these and other parameters (i.e. IL-6, WBC, platelet count, CRP, pH and lactate). Results: Included were 24 boys, 13 girls [median (range) GA 28 weeks (24-36), median birth weight 1,190 g (570-2,400)]. I-FABPu correlated strongly with I-FABPp (r 0.80, p < 0.001) with an adequate agreement. A very strong correlation between I-FABPu and I-FABPu/urine creatinine ratio (r 0.98, p < 0.001) existed. Correlations between I-FABPp/u and conventional parameters were moderate to strong until 8 h after onset of symptoms. Conclusion: In neonates with suspected NEC, I-FABPu correlates strongly with I-FABPp, offering an opportunity to choose the most appropriate way of measuring I-FABP. Calculating urinary IFABP/creatinine ratio seems redundant. Moderately strong correlations between I-FABPu and IL-6, WBC and lactate were found.

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“…Delay or interruption in enteral feeding can lead to inhibition of hormonal secretion and impairment of gastrointestinal adaptation among newborns with very low birth weight (21,22). Feeding problems in our patients can be explained by this mechanism considering the absence of anatomical disorders.…”

Section: Discussionmentioning

confidence: 74%

The Evaluation of Our Newborns Cases Operated due to Necrotizing Enterocolitis

Korkmaz¹,

Baştuğ²,

Daar³

et al. 2017

J Turgut Ozal Med Cent

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Aim: This study aimed to investigate the characteristics of newborns operated due to necrotizing enterecolitis (NEC) in newborn intensive care unit and to evaluate the mortality of these patients. Material and Methods: The research was designed retrospectively. The study included 39 patients operated due to NEC in our newborn intensive care unit between January 2010 and December 2015 and their characteristic factors and prognosis were evaluated. Results: The average gestational age and weight at birth of the newborns were 31.5±3.7 weeks, 1861±817 g respectively. There were significant differences between the newborns who died and survived in respect to birth weight, age at the time of operation, presence of antenatal steroid application, hypoxic ischemic encephalopathy, intestinal presence of perforation, blood culture positivity (p<0.05 for all comparisons). Conclusion: NEC is the most common life-threatening gastrointestinal emergency experienced by premature infants cared for in the newborn intensive care unit. It is thought that the most important ethiologic factors are prematurity, hypoxia and enteral nutrition. At the same time, it is a devastating gastrointestinal disease that is associated with severe sepsis, intestinal perforation, and significant morbidity and mortality. Its mortality and morbidity rates have been reduced due to developments in newborn intensive care. However, mortality rate is still high among newborns operated due to NEC. For these reasons our thought is that promptly arranged operation time can help to reduce the frequency of mortality.

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Laboratory parameters predictive of developing necrotizing enterocolitis in infants born before 33 weeks of gestation

Cited by 56 publications

References 21 publications

C5a, A Complement Activation Product, Is a Useful Marker in Predicting the Severity of Necrotizing Enterocolitis

C5a, A Complement Activation Product, Is a Useful Marker in Predicting the Severity of Necrotizing Enterocolitis

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

The Evaluation of Our Newborns Cases Operated due to Necrotizing Enterocolitis

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