scholarly journals A Modern View on the Diagnosis and Treatment of Necrotizing Enterocolitis in Newborns

2020 ◽  
Vol 13 (4) ◽  
pp. 362-370
Author(s):  
Irina Yu Karpova ◽  
Daria V Molchanova ◽  
T M Ladygina
Keyword(s):  
Necrotizing Enterocolitis ◽  
Pneumatosis Intestinalis ◽  
Diagnosis And Treatment ◽  
Bowel Loop ◽  
Laboratory Diagnostics ◽  
Vacuum Therapy ◽  
Special Role ◽  
Abdominal Organs ◽  
Diagnostic Role ◽  
Quantitative Changes

The aim of the study is to present modern methods of diagnosis and treatment of necrotizing enterocolitis (NEC) in newborns.According to Russian and foreign literature, up to 7.2% of newborns with NEC are admitted to intensive care units. The overall mortality rate in enterocolitis remains at the level of 15%, and in the surgical stages of the disease ranges from 26 to 31%.It is known that the transferred hypoxia and asphyxia lead to vascular disorders. In addition, colonization of the intestine by pathogenic flora takes the leading place in the progression of the process.In order to diagnose NEC, an overview X-ray of the abdominal organs is performed, which reveals such typical changes as: pneumatosis intestinalis, pneumoperitoneum, gastric dilatation, and the presence of a static bowel loop. Ultrasound examination of the abdominal organs confirms enterocolitis in 90% of cases. If necessary, instrumental examination findings are assessed in dynamics. Quantitative changes in the parameters of procalcitonin, calprotectin, cathelicidin, alkaline phosphadase are detected with the help of laboratory diagnostics. It is noted that TGF-1, FXIII factors, thymic index (TI), proteins (FABP2, claudin-2, GFAP) parameters vary at different stages of the disease.Researchers highlight the importance of NEC prevention, a special role is given to breastfeeding. Treatment of necrotizing enterocolitis depends on the stage of the disease and the severity of symptoms, and consists of conservative therapy and surgical correction. The timeliness and necessity of prescribing antibiotics is being actively discussed. Most surgeons emphasize the therapeutic and diagnostic role of laparocentesis; the imposition of preventive intestinal stomas is considered the operation of choice. The medical periodical publications present the experience of using laparoscopy in newborns with the surgical stage of NEC. In addition to the generally accepted methods of treatment, researchers suggest options aimed at improving the clinical outcome of disease correction (vacuum therapy, the introduction of an "oxygen cocktail").

Timing of Optimal Surgical Intervention for Neonates with Necrotizing Enterocolitis

2015 ◽  
Vol 81 (5) ◽  
pp. 438-443 ◽  
Author(s):  
Anthony J. Munaco ◽  
Michellea Veenstra ◽  
Evan Brownie ◽  
Logan A. Danielson ◽  
Kartheek B. Nagappala ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Surgical Intervention ◽  
Abdominal Mass ◽  
Retrospective Chart Review ◽  
Pneumatosis Intestinalis ◽  
Optimal Timing ◽  
Bowel Loop ◽  
Palpable Abdominal Mass ◽  
Indicator Score ◽  
Simple Indicator

Up to half of all patients with necrotizing enterocolitis require acute surgical treatment. Determining when to operate on these patients can be challenging. Utilizing a combination of clinical and metabolic indicators, we sought to identify the optimal timing of surgical intervention. A retrospective chart review was conducted on patients with necrotizing enterocolitis from 2001 to 2010. Previously validated clinical (abdominal erythema, palpable abdominal mass, hypotension), radiographic (pneumoperitoneum, portal venous gas, fixed bowel loop, severe pneumatosis intestinalis), and laboratory (acidosis, bacteremia, hyponatremia, bandemia, neutropenia, thrombocytopenia) indicators were assessed for the ability to predict the need for acute surgical intervention as a simple indicator score, based on the sum of the indicators listed above. A total of 197 patients were included. One hundred and twenty-four procedures (28 peritoneal drains, 96 laparotomy) were performed on 122 patients (62%). Median indicator score was 4 (range: 0–8). Logistic regression identified abdominal erythema (odds ratio [OR] = 3.3, P = 0.001), acidosis (OR = 2.6, P = 0.004), and hypotension (OR = 1.9, P = 0.05) as independently associated with surgical intervention. A significant increase in surgical intervention was noted for patients with indicator score of 3 or more. In conclusion, if three or more indicators exist, operative intervention is very likely required. In the absence of pneumoperitoneum, abdominal erythema, acidosis, and hypotension are especially important.

scholarly journals Is Elastography Useful in Assessing Necrotizing Enterocolitis in Rats?

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Kadir Oymen Hancerliogullari ◽  
Alptekin Tosun
Keyword(s):  
Necrotizing Enterocolitis ◽  
Terminal Ileum ◽  
Color Image ◽  
Ultrasound Elastography ◽  
Diagnosis And Treatment ◽  
Control Group ◽  
Tissue Stiffness ◽  
Gray Scale ◽  
Reliable Technique ◽  
Linear Probe

Background: Necrotizing enterocolitis (NEC) is among the most common and destructive diseases in the neonatal period. Imaging methods are important in the early diagnosis and treatment of such diseases. Ultrasound elastography (USE) is a fast and non-invasive imaging technique that deals with the viscoelastic properties of tissues. Objectives: The purpose of this study is to assess the effectiveness of USE, which determines tissue stiffness with grayscale and colored images, as an imaging tool in the diagnosis and treatment of NEC. Materials and Methods: Sixteen newborn Wistar albino gender rats were separated into two groups including eight rats each. The first group (G-I) was taken as a control group and was not exposed to any intervention. The second group (G-II) was exposed to 100% CO2 for 5 minutes and 4°C for 10 minutes. All these interventions were applied twice per day for 4 days. We observed elastographic data at 24, 48, and 96 hours. All rats were sacrificed on the fourth day. The combination of gray-scale US and elastography was performed by a 4-13 MHz with an average of 12 MHz bandwidth linear probe in Esaote Ultrasonography Systems, MyLab60 model, produced in Geneva, Italy; with ElaXto imaging application. Results: Statistically significant differences were detected in elastosonography ratios of terminal ileum at 24, 48, and 96 hours (P < 0.05). As ischemia period in NEC was prolonged, elastosonographic ratios of intestinum increased significantly. Conclusion: It was found that USE is a reliable technique with superior features in the assessment of the terminal ileum in the neonatal age group. It is due to its wide image window and better assessment of tissue stiffness with gray scale and color image. It has been observed that the USE technique is helpful in the diagnosis.

scholarly journals Recommendations of the Eurasian Arrhythmology Association (EURA) for the diagnosis and treatment of patients with arrhythmias and conduction disorders during the COVID-19 pandemic

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 4-8
Author(s):  
Yu. N. Belenkov ◽  
V. A. Snezhitskiy ◽  
A. V. Ardashev ◽  
S. A. Abzaliyeva ◽  
Riccardo Cappato ◽  
...  
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Heart Rhythm ◽  
Diagnosis And Treatment ◽  
Laboratory Diagnostics ◽  
Functional Diagnostics ◽  
Conduction Disorders ◽  
Specialized Care ◽  
Prevention And Therapy

The beginning of 2020 was characterized by the development of a new coronavirus pandemic (COVID-19). Information about the epidemiology, etiology, pathogenesis, clinical and laboratory diagnostics, as well as prevention and therapy for this disease is constantly being expanded and reviewed. The COVID-19 pandemic creates the need for the emergence of new conditions of specialized care for patients with heart rhythm and conduction disorders [1]. These recommendations are intended for general practitioners, internists, cardiologists, electrophysiologists/arrhythmologists, cardiovascular surgeons, functional diagnostics doctors, anesthesiologists-resuscitators, laboratory diagnostics specialists, health care organizers in the system of organizations and healthcare institutions that provide specialized care to patients with heart rhythm and conduction disorders.

Pneumatosis intestinalis and necrotizing enterocolitis associated with liver cirrhosis

1996 ◽  
Vol 31 (4) ◽  
pp. 596-598
Author(s):  
Yukihiko Tameda ◽  
Minoru Hamada ◽  
Tetsuya Hamaguchi ◽  
Kazushi Sugimoto ◽  
Hiroya Katou ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Necrotizing Enterocolitis ◽  
Pneumatosis Intestinalis
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