Prophylactic Indomethacin and Intestinal Perforation in Extremely Low Birth Weight Infants

Kelleher, John; Salas, Ariel A.; Bhat, Ramesh M; Ambalavanan, Namasivayam; Saha, Shampa; Stoll, Barbara J.; Bell, Edward F.; Walsh, Michele C.; Laptook, Abbot R.; Sánchez, Pablo J.; Shankaran, Seetha; VanMeurs, Krisa P.; Hale, Ellen C.; Newman, Nancy S.; Ball, Michelle; Das, Abhik; Higgins, Rosemary D.; Peralta‐Carcelen, Myriam; Carlo, Waldemar A.

doi:10.1542/peds.2014-0183

Cited by 33 publications

(22 citation statements)

References 28 publications

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“…Recommendations 3B and 3C: Clinical practice of defining intestinal readiness for oral intake or EN in infants varies 9 . EN in the neonate has been safely provided in circumstances involving mechanical ventilation, medications including indomethacin in the presence of a patent ductus arteriosus, and the presence of umbilical catheters 10 , 11 . Recent data suggest that safe feeding practices may not need to include routine measurement of prefeeding gastric residuals 12 , 13 .…”

Section: Question 3: What Clinical Factors Should Be Assessed To Detementioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

180

202

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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Section: Question 3: What Clinical Factors Should Be Assessed To Detementioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

180

202

View full text Add to dashboard Cite

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“…Early organization of postnatal glucocorticoids expands the danger of SIP . However, our case did not receive postnatal or antenatal glucocorticoid treatment (9). In spite of the fact that the postnatal utilization of indomethacin had been already answered to build the danger of SIP , ensuing productions have reported no relationship between indomethacin introduction and SIP (9,10).…”

Section: Discussionmentioning

confidence: 67%

Oral Ibuprofen Induced Spontaneous Intestinal Perforation in a Preterm Infant

Hamilçıkan¹,

Büke²,

Bent³

et al. 2017

jpr

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“…The use of NSAIDs has also been implicated in the development of NEC and is more likely to be agent specific [44,45]. Like caffeine studies, a significant change in mesenteric artery BFV occurs with rapid administration (infused over 20 to 35 minutes) of indomethacin [46,47].…”

Section: Discussionmentioning

confidence: 99%

“…Of note, the default infusion time of indomethacin at our institution is one hour. Although mixed, the literature has shown an increase in NEC with indomethacin use, while spontaneous intestinal perforations are more closely associated with ibuprofen lysine use [44,45].…”

Section: Discussionmentioning

confidence: 99%