Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid Stoffw Microb

Harutyunyan, AS; Muradyan, AA; Hovhannisyan, MG; Badalyan, AR; Lorenc, DV; Nikogosyan, KV; Atyan, TN; Baveyan, BA; Sargsyan, KM; Babloyan, AS.
THE TRANSFORMATION OF MULTI-MODAL 3 COMPONENT PREVENTIVE SCHEME INTO TREATMENT PROTOCOL FOR NECROTIZING ENTEROCOLITIS IN NEWBORNS
NEW ARMEN MED J. 2019; 13(3): 89-102.
Web of Science

Co-Autor*innen der Med Uni Graz: Sargsyan Karine
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Abstract:: Necrotizing enterocolitis (NEC) is the leading cause of death from gastrointestinal disease in premature infants treated in neonatal intensive care unit (NICU) At the present time the unified universally accepted set of informative diagnostic criteria has not been developed yet to allows specifically determine the stage of the disease for the diagnose and treatment strategy. That is why comparing the results of various NEC treatment programs is very difficult. At the Department of Pediatric Surgery and Division of Neonatology of Medical University of Graz (Austria) the implementation of NEC prevention protocol resulted in a very low incidence of NEC. The Graz protocol consists originally of enteral application of a Probiotic (Lactobacillus rhamnosus), in combination with enteral application of an antibiotic (Gentamicin) and an antifungal substance (Nystatin). Methods: The preventive multi-modal 3-component NEC prophylaxis scheme was implemented for NEC treatment in December of 2016 in Neonatology Intensive Care Unit of "Muratsan" clinical complex of Yerevan State Medical University. The retrospective observational study was performed to assess the effectiveness of multi-modal 3-component NEC prophylaxis scheme used as part of the treatment among patients with NEC during 01.12.2015-30.11.2016 (period A), 01.12.2016-30.11.2017 (period B) and 01.12.2017-30.11.2018 (period C). All observed patients were divided in to intervention and control groups. Results: The mortality rate in control group was 38 infants (40%) compared to the intervention group was 13 infants (13%) (p= 0-0001). The implementation of multi-modal 3-component NEC prophylaxis scheme into treatment protocol for NEC resulted in reduction of NEC development from 37% to 12%. Newborns' total mortality decreased from 11% to 6%, wherein the NEC mortality decreased from 16% to zero, and mortality with NEC diagnose included decreased from 34% to 14%. The number of advanced NEC decreased from 33% to 2% and it should be noted that the number of surgical interventions decreased from 21 to zero. The complete recovery at discharge increased from 50% to 86%. Conclusion: The implementation of multi-modal 3-component NEC prophylaxis scheme into treatment protocol for NEC shows significantly reduction in NEC associated morbidity and mortality. The NEC development process in NICU also shows the positive dynamic after multi-modal 3-component NEC prophylaxis scheme administration among newborns with high risk of NEC development.
Find related publications in this database (Keywords): necrotizing enterocolitis; newborns; multi-modal scheme; NEC-prophylaxis; Gentamicin sulfate; Nystatin; LactoG (synbiotic)