Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Zani, A; Eaton, S; Puri, P; Rintala, R; Lukac, M; Bagolan, P; Kuebler, JF; Hoellwarth, ME; Wijnen, R; Tovar, J; Pierro, A; EUPSA Network.
International survey on the management of necrotizing enterocolitis.
Eur J Pediatr Surg. 2015; 25(1):27-33
Doi: 10.1055/s-0034-1387942
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- Co-authors Med Uni Graz
- Höllwarth Michael
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- Abstract:
- The aim of this study is to define patterns in the management of necrotizing enterocolitis (NEC). A total of 80 delegates (81% senior surgeons) from 29 (20 European) countries completed a survey at the European Pediatric Surgeons' Association 2013 annual meeting. Overall, 59% surgeons work in centers where>10 cases of NEC are treated per year. 76% surgeons request both anteroposterior and lateral abdominal X-rays, which are performed at regular intervals by 66%; 50% surgeons also request Doppler ultrasonography; most frequently used biochemical markers are platelets (99% of surgeons), C-reactive protein (90%), and white cell count (83%). Laparoscopy is performed for diagnosis and/or treatment of NEC by only 8% surgeons. Overall, 43% surgeons reported being able to diagnose focal intestinal perforation preoperatively. Medical NEC: medical NEC is managed by surgical and neonatal teams together in most centers (84%). Most surgeons (67%) use a combination of two (51%) or three (48%) antibiotics for more than 7 days, and keep patients nil by mouth for 7 (41%) or 10 (49%) days. Surgical NEC: In extremely low-birth-weight infants (< 1,000 g) with intestinal perforation, 27% surgeons opt for primary peritoneal drainage (PPD) as definitive treatment. Overall, 67% think that peritoneal drainage is important for stabilization and transport. At laparotomy, treatments vary according to NEC severity. About 75% surgeons always close the abdomen, and 29% leave a patch to prevent compartment syndrome. Infants are kept nil by mouth for 5 to 7 days by 46% surgeons, more than 7 days by 42%, and less than 5 days by 12% surgeons. Most surgeons (77%) restart infants on breast milk, 11.5% on aminoacid-based formulas, and 11.5% on hydrolyzed formulas. Most surgeons (92%) follow-up NEC patients after discharge, up to 5 years of life (56%) and 65% surgeons organize a neurodevelopmental follow-up. Many aspects of NEC management are lacking consensus and surgeons differ especially over surgical treatment of complex cases and postoperative management. Prospective multi-center studies are needed to guide an evidence-based management of NEC. Georg Thieme Verlag KG Stuttgart · New York.
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- Enterocolitis, Necrotizing - diagnosis
- Enterocolitis, Necrotizing - drug therapy
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- Postoperative Care - methods
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- Practice Patterns, Physicians' - statistics & numerical data
- Find related publications in this database (Keywords)
- NEC
- premature infant
- questionnaire