Necrotizing enterocolitis in the unfed infant

Marchildon, Michael B.; Buck, B E; Abdenour, George E.

doi:10.1016/s0022-3468(82)80122-x

Cited by 37 publications

(10 citation statements)

References 13 publications

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“…23 enteral feeding NEC predominantly occurs in babies who have been enterally fed, 24 although it has occasionally been reported in completely unfed babies. 25,26 Feeding with formula milk appears to increase the risk of NEC, whereas breast milk has a protective effect. 27,28 The timing of initiation and speed of increase of enteral feeds is a subject of much debate.…”

Section: Bacterial Colonizationmentioning

confidence: 99%

Necrotizing enterocolitis: current perspectives

Yajamanyam

Rasiah²,

Ewer³

2014

RRN

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Necrotizing enterocolitis is the most common gastrointestinal emergency in neonates, particularly in those born very preterm. It is a leading cause of morbidity and mortality, especially in extremely low birth weight infants. Despite extensive research, the pathophysiology of necrotizing enterocolitis remains unclear and therapeutic options are limited. Multiple risk factors have been reported, but most are associated with prematurity and its complications. This makes management very challenging in vulnerable preterm infants. In this review, we focus on the risk factors and some of the current research in this area, particularly studies aimed at early detection and potential preventive measures for this potentially lethal condition.

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Section: Bacterial Colonizationmentioning

confidence: 99%

Necrotizing enterocolitis: current perspectives

Yajamanyam

Rasiah²,

Ewer³

2014

RRN

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“…The role of feeding practices has long been implicated in the development of NEC in premature infants. In 1982, Marchildon et al 20 described the occurrence of NEC in a group of 14 infants who had never been enterally fed. Fifty percent of this group progressed to severe disease.…”

Section: Feeding Issuesmentioning

confidence: 99%

Clinical parameters do not adequately predict outcome in necrotizing enterocolitis: a multi-institutional study

et al. 2008

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Objective: Necrotizing enterocolitis (NEC) remains a major cause of neonatal morbidity and mortality. Some infants recover uneventfully with medical therapy whereas others develop severe disease (that is, NEC requiring surgery or resulting in death). Repeated attempts to identify clinical parameters that would reliably identify infants with NEC most likely to progress to severe disease have been unsuccessful. We hypothesized that comprehensive prospective data collection at multiple centers would allow us to develop a model which would identify those babies at risk for progressive NEC.Study Design: This prospective, observational study was conducted at six university children's hospitals. Study subjects were neonates with suspected or confirmed NEC. Comprehensive maternal and newborn histories were collected at the time of enrollment, and newborn clinical data were collected prospectively, thereafter. Multivariate logistic regression analysis was used to develop a predictive model of risk factors for progression.Result: Of 455 neonates analyzed, 192 (42%) progressed to severe disease, and 263 (58%) advanced to full feedings without operation. The vast majority of the variables studied proved not to be associated with progression to severe disease. A total of 12 independent predictors for progression were identified, including only 3 not previously described: having a teenaged mother (odds ratio, OR, 3.14; 95% confidence interval, CI, 1.45 to 6.96), receiving cardiac compressions and/or resuscitative drugs at birth (OR, 2.51; 95% CI, 1.17 to 5.48), and having never received enteral feeding before diagnosis (OR, 2.41; 95% CI, 1.08 to 5.52). Conclusion:Our hypothesis proved false. Rigorous prospective data collection of a sufficient number of patients did not allow us to create a model sufficiently predictive of progressive NEC to be clinically useful. It appears increasingly likely that further analysis of clinical parameters alone will not lead to a significant improvement in our understanding of NEC. We believe that future studies must focus on advanced biologic parameters in conjunction with clinical findings.

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“…Na amostra estudada, a ocorrência de PCA foi igual em ambos os grupos, não sendo um fator predisponenete à doença. 20 .…”

Section: Discussionunclassified