Necrotizing Enterocolitis

Neu, Josef

doi:10.1016/s0031-3955(05)70413-2

Cited by 295 publications

(65 citation statements)

References 112 publications

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“…[10] Congenital malformation, including congenital heart diseases (CHDs), gastrointestinal (GI) abnormalities, inborn errors of metabolism (IEM), and other abnormalities, is based on the child's clinical presentation at admission and screening with the aid of X-ray, ultrasound scan, echocardiography, and computed tomography scan when applicable. Early and late neonatal periods are defined as 0–6 days of age and 7–27 days of age, respectively.…”

Section: Methodsmentioning

confidence: 99%

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China

Wang

et al. 2016

Chinese Medical Journal

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Background:Globally, the proportion of child deaths that occur in the neonatal period remains a high level of 37–41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.Methods:All the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011. All the data were collected retrospectively from clinical records by a designed questionnaire. Data collected from each NICU were delivered to the leading institution where the results were analyzed.Results:A total of 744 newborns died during the 1-year survey, accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals. Preterm neonate death accounted for 59.3% of all the death. The leading causes of death in preterm and term infants were pulmonary disease and infection, respectively. In early neonate period, pulmonary diseases (56.5%) occupied the largest proportion of preterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths. In late neonate period, infection was the leading cause of both preterm and term neonate deaths. About two-thirds of neonate death occurred after medical care withdrawal. Of the cases who might survive if receiving continuing treatment, parents’ concern about the long-term outcomes was the main reason of medical care withdrawal.Conclusions:Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age. Our study showed the majority of neonate death occurred in preterm infants. Cause of death varied with the age of death and gestational age. Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

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Section: Methodsmentioning

confidence: 99%

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China

Wang

et al. 2016

Chinese Medical Journal

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“…The modified Bell staging criteria were used to determine NEC incidence [9]. These criteria classify NEC as either suspected (IA and IB), proven (IIA and IIB) and advanced (IIIA and IIIB).…”

Section: Methodsmentioning

confidence: 99%

Abnormal Abdominal Aorta Hemodynamics Are Associated With Necrotizing Enterocolitis in Infants With Hypoplastic Left Heart Syndrome

et al. 2013

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Background The risk of necrotizing enterocolitis (NEC) in association with congenital heart disease is highest in patients with hypoplastic left heart syndrome (HLHS). Within the HLHS population, however, risk factors for NEC remain debated. We hypothesized that some infants with HLHS have vascular changes that contribute to gut hypoperfusion, independent of diastolic run-off and low cardiac output. Methods We analyzed the abdominal aorta pulsatility index and right ventricular function on routine pre-operative and post-operative echocardiograms for all infants who underwent stage I palliation for HLHS from January 2007 to January 2012. The echocardiography findings and clinical course were compared between those with and those without an episode of NEC. Results Of the 61 cases reviewed, 11 (18%) developed NEC during a mean follow-up of 3.8 ±1.3 years. Those with NEC had a lower abdominal aorta pulsatility index compared to those without NEC both on stage I pre-operative (3.38 ±0.15 vs. 3.89 ±0.09, p<0.05) and post-operative echocardiograms (2.21 ±0.28 vs. 3.05 ±0.78, p=0.01) despite similar ventricular function and operative risk. Conclusions Abdominal aorta Doppler pulsations are lower in patients with HLHS whose clinical course is complicated by NEC. This finding suggests that the systemic vasculature in a subset of neonates with HLHS may be inherently abnormal. Further investigation is warranted to determine if this is secondary to structural changes in the mesenteric and/or systemic vasculature.

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“…Current evidence implicates multiple risk factors in the pathogenesis of NEC [5]. These include prematurity, aggressive initiation of enteral feeding, congenital heart disease, bacterial infection, maternal cocaine use, and respiratory distress syndrome [6][7][8][9][10][11]. The incidence of NEC continues to rise because recent advances in neonatal medicine have resulted in the survival of infants born at less than 24 weeks gestation [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Current concepts regarding the pathogenesis of necrotizing enterocolitis

et al. 2009

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Necrotizing enterocolitis (NEC) is a devastating disease that predominantly affects premature neonates. The mortality associated with NEC has not changed appreciably over the past several decades. The underlying etiology of NEC remains elusive, although bacterial colonization of the gut, formula feeding, and perinatal stress have been implicated as putative risk factors. The disease is characterized by massive epithelial destruction, which results in gut barrier failure. The exact molecular and cellular mechanisms involved in this complex disease are poorly understood. Recent studies have provided significant insight into our understanding of the pathogenesis of NEC. Endogenous mediators such as prostanoids, cyclooxygenases, and nitric oxide may play a role in the development of gut barrier failure. Understanding the structural architecture of the gut barrier and the cellular mechanisms that are responsible for gut epithelial damage could lead to the development of novel diagnostic, prophylactic and therapeutic strategies in NEC.

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Necrotizing Enterocolitis

Cited by 295 publications

References 112 publications

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China

Abnormal Abdominal Aorta Hemodynamics Are Associated With Necrotizing Enterocolitis in Infants With Hypoplastic Left Heart Syndrome

Current concepts regarding the pathogenesis of necrotizing enterocolitis

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