Role of delayed feeding and of feeding increments in necrotizing enterocolitis

McKeown, Robert E.; Marsh, T. David; Amarnath, Uma M.; Garrison, Carol Z.; Addy, Cheryl L.; Thompson, Shirley; Austin, Tom L.

doi:10.1016/s0022-3476(05)81913-4

Cited by 106 publications

(41 citation statements)

References 14 publications

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“…Nevertheless, as each case is unique, the osmolarity of the powdered whole milk offered to the calf in this study from the fifth day on may have contributed to the development of enterocolitis with pneumatosis. As lactose is naturally lacking or present only in small amounts in T. inunguis milk (Bar-bosa 2011), the elevated osmolarity and/or overnutrition could result in malabsorption of lactose carbohydrates; this would increase the concentration of this sugar in the large intestine, metabolized by bacteria, with production of hydrogen and short-chain organic acids extremely harmful to the intestinal mucosa, leading to the development of enterocolitis (McKeown et al 1992). With the disruption of the mucosal barrier, bacteria penetrated the intestinal wall, and gas production by the bacteria caused the formation of pneumatosis.…”

Section: Discussionmentioning

confidence: 99%

Acute necrotizing colitis with pneumatosis intestinalis in an Amazonian manatee calf

Neto

Bueno²,

Silva³

et al. 2016

Dis. Aquat. Org.

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On 25 January 2014, a 1 mo old female Amazonian manatee Trichechus inunguis calf weighing 12 kg was rescued by air transport in Guajará, Brazil, and transferred to Mamirauá Institute's Community-based Amazonian Manatee Rehabilitation Center. The calf presented piercing/ cutting lesions on the back, neck, and head, in addition to dehydration and intermittent involuntary buoyancy. X-ray analysis revealed a large amount of gases in the gastrointestinal tract. Daily procedures included wound cleaning and dressing, clinical and laboratory monitoring, treatment for intestinal tympanism, and artificial feeding. Adaptation to the nursing formula included 2 kinds of whole milk. Up to 20 d post-rescue the calf presented appetite, was active, and gained weight progressively. Past this period the calf started losing weight and presented constant involuntary buoyancy and died after 41 d in rehabilitation. The major findings at necropsy were pneumatosis intestinalis in cecum and colon, pulmonary edema, and hepatomegaly. The microscopic examination revealed pyogranulomatous and necrohemohrragic colitis with multinucleated giant cells, acute multifocal lymphadenitis with lymphoid depletion in cortical and paramedullary re gions of mesenteric lymph nodes, and diffuse severe acinar atrophy of the pancreas. Anaerobic cultures of fragments of cecum and colon revealed colonies genotyped as Clostridium perfringens type A. We speculate that compromised immunity, thermoregulatory failure, and intolerance to artificial diet may have been contributing factors to the infection, leading to enterotoxemia and death.

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Section: Discussionmentioning

confidence: 99%

Acute necrotizing colitis with pneumatosis intestinalis in an Amazonian manatee calf

Neto

Bueno²,

Silva³

et al. 2016

Dis. Aquat. Org.

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show abstract

“…demonstraram que aumentos diários no volume da dieta acima de 20 ml/kg/dia aumentavam significativamente o risco de enterocolite 24 . Em contraposição a essas observações, Raysis e cols.…”

Section: Discussionunclassified

Factors associated with necrotizing enterocolitis

Vieira¹,

Lopes²

2003

J Pediatr (Rio J)

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“…Currently, most mothers and health institutions in the Saudi community still profusely rely on breast milk substitutes, a practice which has been identified as a possible etiological factor in NEC. 10 Perhaps the process of transporting infants from the referring hospital, with catheters and endotracheal tubes inserted in these sick infants, has rendered our subjects highly susceptible to infection. This may explain the relative importance of sepsis in our list, compared with the experience in other centers whose patients are taken directly from their annexed delivery units.…”

Section: Discussionmentioning

confidence: 99%