scholarly journals Necrotizing Enterocolitis with Perforation in an Extreme Preterm, Extremely Low Birth Weight Neonate

2016 ◽  
Vol 36 (2) ◽  
pp. 201-203
Author(s):  
Shridhar Gopalakrishnan ◽  
Shailendra Singh ◽  
Kirandeep Sodhi ◽  
Manu Arora
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Surgical Management ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Good Outcome ◽  
Birth Weight Neonate ◽  
Surgical Condition

Necrotizing enterocolitis (NEC) remains the most common and serious surgical condition among preterm, very low birth weight neonates with a mortality of 40% to 50% in those requiring surgery. We report perforation secondary to NEC in an extreme preterm, extremely low birth weight neonate with a good outcome due to aggressive surgical management and intensive care.J Nepal Paediatr Soc 2016;36(2):201-203.

scholarly journals Outcome of primary peritoneal drainage in perforated necrotizing enterocolitis: an experience with 96 infants

2021 ◽  
Author(s):  
Kumar Abdul Rashid ◽  
Reyaz Ahmad Wani ◽  
Shafat Ahmad Tak ◽  
Omar Masood ◽  
Amat U. Samie ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Exploratory Laparotomy ◽  
Extremely Low Birth Weight ◽  
Major Surgery ◽  
Low Birth Weight Infants ◽  
Peritoneal Drainage

Background: Necrotizing enterocolitis is a life-threatening inflammation of neonatal intestine of multifactorial etiology. In early stages, medical management is considered; while as a transmural disease with pneumatosis or perforation needs surgical attention. Primary peritoneal drainage has evolved as an alternative to classic exploratory laparotomy especially in sick preterm and very low birth weight infants.Methods: In our study, we tried to employ primary peritoneal drainage as an initial intervention in all surgical necrotizing enterocolitis patients and analyzed the results and final outcome in terms of total days in neonatal intensive care unit, total parenteral nutrition days, days to start oral feeds, need for laparotomy, mortality and other complications.Results: Around one-third patients were either very low or extremely low birth weight and 80% patients were preterm. Primary peritoneal drainage was successful without need for laparotomy in around 65% of patients. In the rest 34 patients, 24 were subjected to rescue laparotomy, while 10 could not be stabilized for major surgery. Overall mortality was 29.16%.Conclusions: Early bedside primary peritoneal drainage can be employed in all cases of NEC with perforation with rescue laparotomy to be determined by subsequent monitoring. This strategy seems to be safe and cost-effective in a resource challenged set up and lifesaving in sick and extremely low birth weight infants.

scholarly journals Routine Administration of a Multispecies Probiotic Containing Bifidobacterium and Lactobacillus to Very Low Birth Weight Infants Had No Significant Impact on the Incidence of Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Brian A. Juber ◽  
Timothy J. Boly ◽  
Graeme J. Pitcher ◽  
Steven J. McElroy
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Vlbw Infants ◽  
Routine Administration ◽  
Significant Difference ◽  
All Cause Mortality

Background: Necrotizing enterocolitis (NEC) is the leading cause of gastrointestinal morbidity in preterm infants, and prevention and treatment strategies have remained largely unchanged over the past several decades. As understanding of the microbiome has increased, probiotics have been hypothesized as a possible strategy for decreasing rates of NEC, and several studies have noted significant decreases in rates of NEC after initiation of probiotics in preterm infants. However, a recent AAP report cited caution on the use of probiotic use in part because studies of probiotic use in ELBW infants are lacking. As our unit began routine use of probiotics for all infants <33 weeks in 2015 and we are a leading institution for intact survival of ELBW infants, we attempted to answer if probiotic use can impact the rate of NEC in VLBW and ELBW infants.Methods: We conducted a single-center retrospective chart review of infants with modified Bell's stage ≥2a NEC for the 4 years prior to and 5 years after initiation of a protocol involving routine supplementation of a multispecies probiotic to premature infants at the University of Iowa, Stead Family Children's Hospital. The primary outcome measures were rates of modified Bell's stage ≥2a NEC and all-cause pre-discharge mortality at our institution before and after initiation of routine probiotic supplementation in 2015.Results: In our institution, neither the rates of modified Bell's stage ≥2a NEC, nor the rates of all-cause mortality were significantly altered in very low birth weight (VLBW) infants by the initiation of routine probiotic use (NEC rates pre-probiotic 2.1% vs. post-probiotic 1.5%; all-cause mortality rates pre-probiotic 8.4% vs. post-probiotic 7.4%). Characteristics of our two cohorts were overall similar except for a significantly lower 5-minute APGAR score in infants in the post-probiotic epoch (pre-probiotic 8 vs. post-probiotic 6 p = 0.0316), and significantly more infants in the post-probiotic epoch received probiotics (pre-probiotics 0% vs. post-probiotics 65%; p < 0.0001). Similarly, probiotic use had no impact on the incidence of NEC when we restricted our data to only extremely low birth weight (ELBW) infants (pre-probiotics 1.6% vs post-probiotics 4.1%). When we restricted our analysis to only inborn infants, probiotics still had no impact on NEC rates in VLBW infants (1.5% pre- and 1.1% post-probiotic, p = 0.61) or ELBW infants (2% pre- and 2.1% post-probiotic, p = 0.99)Conclusions: Contrary to other studies, we found no significant difference in rates of modified Bell's stage ≥2a NEC or all-cause pre-discharge mortality in VLBW infants following routine administration of a multispecies probiotic supplement.

Exploratory Laparotomy for Necrotizing Enterocolitis

2013 ◽  
Author(s):  
Dugald McAdam
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Survival Rates ◽  
Exploratory Laparotomy ◽  
Extremely Low Birth Weight ◽  
Life Threatening Illness ◽  
Antenatal Steroids ◽  
Neonatal Lung

The survival rates of very-low-birth weight (VLBW; birth weight <1,500 g) and extremely-low-birth weight (ELBW; birth weight <1,000 g) infants have increased with improvements in antenatal and postnatal care. These include the use of antenatal steroids, artificial surfactant, and ventilation strategies that have reduced injury to the neonatal lung. As a result, the pediatric anesthesiologist is now more often faced with the task of safely caring for these infants, often in unfamiliar environments, and sometimes during episodes of life-threatening illness. One example is necrotizing enterocolitis (NEC) requiring surgical management.

Probiotics for Preterm Infants: A Premature or Overdue Necrotizing Enterocolitis Prevention Strategy?

2015 ◽  
Vol 34 (2) ◽  
pp. 83-101 ◽  
Author(s):  
Sharon Anderson
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Prevention Strategy ◽  
Extremely Low Birth Weight ◽  
High Risk Population ◽  
Ongoing Research ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

AbstractCommon among preterm, very low birth weight (VLBW) and extremely low birth weight (ELBW) infants, necrotizing enterocolitis (NEC) is a gastrointestinal, infectious disease that remains a leading cause of morbidity and mortality among this high-risk population. To combat this devastating condition, research efforts have been redirected from treatment toward prevention strategies. Although there are several proposed risk-reduction strategies, one intervention gaining support is the administration of prophylactic enteral probiotics. Regardless of growing evidentiary support and a benign safety profile, neonatal providers have yet to embrace this therapy. This article provides an overview of the proposed benefits of probiotics, focusing on their role as a NEC prevention strategy. A review of several sentinel research studies targeting preterm, VLBW, and ELBW infants is provided. Considerations for ongoing research are reviewed. Finally, two evidence-based NEC prevention probiotics protocols are presented.

Spontaneous liver hemorrhage during laparotomy in a very low birth weight neonate with necrotizing enterocolitis: A case report

2010 ◽  
Vol 3 (3) ◽  
pp. 229-232
Author(s):  
Abhaya Gupta ◽  
Rahul K. Gupta ◽  
Vinay Jadhav ◽  
Hemanshi Shah ◽  
Beejal Sanghvi ◽  
...  
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Birth Weight Neonate

scholarly journals Extended Interval Aminoglycoside Treatment for Klebsiella Pneumoniae Endocarditis in an Extremely Low Birth Weight Neonate

2021 ◽  
Vol 27 (1) ◽  
pp. 85-89
Author(s):  
Justin Simpkins ◽  
Sarah Miller ◽  
Debbie-Ann Shirley
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Klebsiella Pneumoniae ◽  
Very Low Birth Weight ◽  
Kidney Injury ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Birth Weight Neonate ◽  
Postmenstrual Age ◽  
Nephron Development

Infective endocarditis (IE) in neonates is associated with high mortality and incidence has been increasing over the past two decades. The majority of very low birth weight infants will be treated with at least one nephrotoxic medication during their hospital course. Over one-quarter of very low birth weight neonates exposed to gentamicin may develop acute kidney injury (AKI); this is particularly worrisome as AKI is an independent factor associated with increased neonatal mortality and increased length of stay. AKI during periods of neonatal nephrogenesis, which continues until 34–36 weeks postmenstrual age, may also have serious effects on the long-term nephron development which subsequently puts infants at risk of chronic kidney disease. Extended interval (EI) aminoglycoside (AMG) dosing has been used for decades in adult populations and has proven to reduce AKI while being at least as effective as traditional dosing, although there is limited published research for using an EI AMG in endocarditis in adults or pediatric patients. We describe an extremely low birth weight neonate, born preterm at 24 weeks gestation treated for Klebsiella pneumoniae IE that required AMG therapy who also had concurrent AKI. We utilized EI AMG combination therapy for treatment of Klebsiella pneumoniae endocarditis with good outcome and encourage others to report their experiences to improve our knowledge of EI AMG in this population.

Reduced Formula Intake with Donor Milk (DM) Impacts Necrotizing Enterocolitis (NEC) in Very Low Birth Weight (VLBW) Infants:

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 443A-443A
Author(s):  
Jennifer S. Wicks ◽  
Anita L. Esquerra-Zwiers ◽  
Laura M. Rogers ◽  
Celina M. Scala ◽  
Shirley Chen ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Donor Milk ◽  
Vlbw Infants

Sentinel bowel loop as a marker for primary segmental intestinal volvulus in extreme low birth weight neonates

2021 ◽  
pp. 1-5
Author(s):  
T. Zahouani ◽  
W.R. Carter ◽  
R.H. Jessel ◽  
D.E. El-Metwally ◽  
H.M. Crowley
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Surgical Management ◽  
Case Series ◽  
Extremely Low Birth Weight ◽  
Bowel Loop ◽  
Clinical Markers ◽  
Low Birth Weight Infants ◽  
Intestinal Volvulus ◽  
Delay In Diagnosis

Primary segmental intestinal volvulus is a rare condition that may affect neonates. This condition occurs when a loop of bowel torses around the axis of its mesentery without any other abnormality or malrotation. In the earlier stages, the diagnosis can be challenging due to the lack of specific clinical and radiographic signs. Prompt surgical management is critical as a delay in diagnosis may result in bowel loss or death. We present a series of three cases of extremely low birth weight infants with primary segmental volvulus. A sentinel bowel loop was critical in guiding each patient’s surgical management as there were no other clinical markers concerning a pending intra-abdominal catastrophe. This case series suggests that a sentinel bowel loop may be a radiographic marker for primary segmental intestinal volvulus in extremely low birth weight infants.

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