Pharmacological interventions for prevention and treatment of upper gastrointestinal bleeding in newborn infants

Green, Daniel S; Abdellatif, Mohamed; Jones, Lisa J; Lui, Kei; Osborn, David A

doi:10.1002/14651858.cd011785.pub2

Cited by 7 publications

(4 citation statements)

References 67 publications

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“…Neonatal upper gastrointestinal hemorrhage is mostly caused by stress ulcers induced by various acute and critical diseases. 8 Modern medicine has discovered that the gastrointestinal mucosa of newborns is delicate and vulnerable due to the influence of physical development. [9][10][11] When the body is traumatic, including shock and septicemia, there will be a series of neuroendocrine compensatory responses, sympathetic excitability and increased catecholamine release, thus contracting gastrointestinal vascular smooth muscle, reducing mucosal blood flow, decreasing mucus secretion and increasing gastrin and pepsin secretion.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of norepinephrine combined with cimetidine in treatment of neonatal upper gastrointestinal hemorrhage and its adverse reactions

Dong¹,

Liu²,

Zhu

2022

Pak J Med Sci

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Neonatal upper gastrointestinal hemorrhage is a common acute and critical neonatal disease, with high-risk factors including asphyxia, premature delivery, low body weight, infection, premature weaning, gastrointestinal lesions and systemic lesions. Affected by bleeding site and volume, its early clinical manifestations are commonly vomiting, abdominal distension, bloody stool, shock and intra-abdominal free gas, which are prone to threaten the life health of infants without timely intervention or treatment. 1,2 At present, the main clinical treatment for neonatal upper gastrointestinal hemorrhage is symptomatic

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of norepinephrine combined with cimetidine in treatment of neonatal upper gastrointestinal hemorrhage and its adverse reactions

Dong¹,

Liu²,

Zhu

2022

Pak J Med Sci

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“… Evitar la supresión del ácido gástrico: En el recién nacido la acidez gástrica regula la cantidad de microorganismos patógenos que colonizan el intestino, lo que previene eventos infecciosos e inflamatorios que conducen a la ECN. El uso de bloqueadores H2 suprime la acidez gástrica, lo que crea disbiosis del microbioma del intestino aumentando el riesgo de ECN por ende se sugiere que se evite su uso en los recién nacidos prematuros con muy bajo peso al nacer (Green et al, 2019). Santos, et.al en un metaanálisis demostraron la asociación entre bloqueadores H2 y ECN (OR combinado: 2,81; IC del 95%: 1,19-6,64; P = 0,02) (Santos et al, 2019).…”

Section: Protocolo De Alimentación Estandarizadounclassified

Enterocolitis Necrosante neonatal: Factores de riesgo y medidas de prevención

Muso Guagchinga,

Philco Toaza

2023

Pentaciencias

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La Enterocolitis Necrosante Neonatal (ECN) es una emergencia gastrointestinal grave, que afecta principalmente a los recién nacidos prematuros, su fisiopatología es multifactorial y la gravedad se puede clasificar mediante el sistema de estadificación de Bell. Se realizó una revisión bibliográfica basada en artículos científicos originales, metaanálisis y revisiones sistemáticas obtenidas de diferentes bases de datos y se analizaron los resultados de 66 artículos científicos. Se determinó que el principal factor de riesgo para ECN es la prematuridad, el mismo que influye en los demás factores de riesgo. Los factores de riesgo se clasificaron en maternos y prenatales, perinatales y del parto y factores de riesgos neonatales tempranos y postnatales. Dentro de las medidas de prevención contra la ECN se hallaron a la alimentación con leche materna, la implementación de un protocolo de alimentación estandarizado, la suplementación con probióticos y la restricción del uso de antibióticos. La prematuridad influye en el desarrollo de ECN por ende es importante que se tomen medidas preventivas para evitar partos prematuros. Por otro lado, la lactancia materna es la estrategia más costo-efectiva contra la ECN por lo que se sugiere un mayor apoyo a la lactancia materna y la instauración de bancos de leche humana.

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“…Despite efforts to limit use of acid suppressants in infants, 1 , 2 , 3 , 4 use of these medications, including both proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs), remains prevalent among both term and preterm infants. 5 , 6 , 7 Relative to term-born infants, those born preterm are treated more often with acid suppressants, with a prevalence of nearly 30% for H2RAs and nearly 20% for PPIs during neonatal intensive care unit (NICU) hospitalization. 8 Further, many preterm-born infants are first exposed to these medications after NICU discharge.…”

Section: Introductionmentioning

confidence: 99%

“…Further, many preterm-born infants are first exposed to these medications after NICU discharge . Although acid suppressants are prescribed for a variety of indications and prophylactically, numerous publications have questioned the benefit of acid suppressant use in children, particularly for the treatment of gastroesophageal reflux . Of particular concern are studies suggesting an association between acid suppressant use and risk of atopy, obesity, bone fractures, and infections in children .…”

Section: Introductionmentioning

confidence: 99%

Analysis of Neurodevelopment in Children Born Extremely Preterm Treated With Acid Suppressants Before Age 2 Years

Jensen

Jackson

et al. 2022

JAMA Netw Open

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ImportanceChildren born preterm are at increased risk of adverse neurodevelopmental outcomes and may be particularly vulnerable to the effects of gastric acid suppression during infancy.ObjectiveTo assess whether early acid suppressant use in infants born extremely preterm is associated with poorer neurodevelopmental outcomes.Design, Setting, and ParticipantsThe Extremely Low Gestational Age Newborn study was a multicenter, longitudinal cohort study of infants born before 28 weeks’ gestational age between March 22, 2002, and August 31, 2004. The current analyses were performed from September 12, 2020, through September 22, 2022. Of the 1506 infants enrolled, 284 died before discharge and 22 died before 24 months of age. An additional 2 died before age 10 years, leaving 1198 (79.5%) eligible for a visit. Of these, 889 (74%) participated in the visit at age 10. At age 10 years, the association of early-life acid suppressant use with neurocognitive, neurodevelopmental, and psychiatric symptomatology was assessed.ExposuresAcid suppressant use before 24 months of age was determined from medical records and from questionnaires administered to mothers.Main Outcomes and MeasuresNeurodevelopmental assessments at age 10 years included the School-Age Differential Ability Scales–II, the Developmental Neuropsychological Assessment-II, the Autism Diagnostic Observation Schedule-2, the Social Responsiveness Scale-2, and the Child Symptom Inventory-4 for attention-deficit/hyperactivity disorder (ADHD), depression, and anxiety.ResultsOf the 889 participants assessed at age 10 years (mean [SD] age, 9.97 [0.67] years; mean [SD] gestational age at birth, 26.1 [1.3] weeks; 455 [51.2%] male), 368 (41.4%) had received acid suppressants by 24 months of age. Associations were observed between acid suppressant use and decreased full-scale IQ z score (adjusted β, −0.29; 95% CI, −0.45 to −0.12), verbal IQ z score (adjusted β, −0.34; 95% CI, −0.52 to −0.15), nonverbal IQ z score (adjusted β, −0.22; 95% CI to −0.39 to −0.05), working memory z score (adjusted β, −0.26; 95% CI to −0.45, −0.08), autism spectrum disorder (adjusted relative risk, 1.84; 95% CI, 1.15-2.95), and epilepsy (adjusted relative risk, 2.07; 95% CI, 1.31 to 3.35). Results were robust to multiple sensitivity analyses. Use of acid suppressants was not associated with inhibitory control, ADHD, anxiety, or depression.Conclusions and RelevanceThe results of this cohort study suggest that early-life use of acid suppressants in extremely preterm infants may be associated with poorer neurodevelopmental outcomes and add to evidence indicating caution in use of these agents.

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Pharmacological interventions for prevention and treatment of upper gastrointestinal bleeding in newborn infants

Cited by 7 publications

References 67 publications

Clinical efficacy of norepinephrine combined with cimetidine in treatment of neonatal upper gastrointestinal hemorrhage and its adverse reactions

Clinical efficacy of norepinephrine combined with cimetidine in treatment of neonatal upper gastrointestinal hemorrhage and its adverse reactions

Enterocolitis Necrosante neonatal: Factores de riesgo y medidas de prevención

Analysis of Neurodevelopment in Children Born Extremely Preterm Treated With Acid Suppressants Before Age 2 Years

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