Necrotizing enterocolitis in the preterm: newborns medical and nutritional Management in a Single-Center Study

Abstract

Necrotizing enterocolitis (NEC) is a typical disorder of preterm newborns, with a high mortality and morbidity rate. The therapeutic and nutritional management of disease depends on several factors. Its prognosis is linked, in addition to the severity of the disease and the need for surgery, to a correct enteral feeding in these patients. This study aims to identify the clinical characteristics of 18 patients with NEC, evaluating the different therapeutic paths undertaken, the type of formula used and the survival rate of this population. Average time of enteral nutrition before the NEC onset was 11,3 ± 11,6 days, with an average fasting period since the onset of 24 ± 18.9 days. 77.8% of patients received surgery and resumed enteral nutrition 17.7 ± 17.9 days after the intervention. The overall survival rate of our cohort was 55.5%. More prospective studies are needed to evaluate the long-term outcomes of survived children with NEC.

Gastrointestinal Emergencies in Neonates: A Review Article

“…The true cause of NEC is unknown but is believed to be related to bowel wall injury, or hypoxia, which leads to inflammation and colonization of the bowel wall by bacterial flora. Some variation in the day of onset of the disease is possible and seems to be related to the gestational age and birth weight of the patient, thus, premature neonates present later with this illness than term infants [2][3][4][5].…”

“…Coffee ground or bilious emesis, guaiac positive, or grossly bloody stool may also develop at the time of evaluation. Shock indicates late presentation in cases of necrotizing enterocolitis and denotes an increased likelihood of intestinal perforation in such cases [3][4][5].…”

“…Other radiographic signs that may be present earlier in the course include findings of bowel wall thickening and dilated loops of the bowel. Ultrasound evaluation can also reveal portal gas and ascites in some cases [2][3][4][5].…”

“…A nasogastric tube should be inserted to decompress the stomach. Because of the severity of this condition, attention should be paid to the patient's response to treatment, and plans for pediatric intensive care unit (PICU) placement should be initiated if needed [3][4][5].…”

New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine

“…Savarino et al [ 125 ] described the clinical characteristics and the different therapeutic paths undertaken of 18 preterm infants with necrotizing enterocolitis. They reported age of onset, duration of previous enteral, as well as total parenteral feeding following surgery.…”