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Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants

Objectives: To investigate the clinical outcomes of ultrasound (US)-detected perforated necrotizing enterocolitis (NEC) without radiographic pneumoperitoneum in very preterm infants. Methods: In this single-center retrospective study, very preterm infants who underwent a laparotomy for perforated NE...

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Autores principales: Kim, Myoung Kyoung, Jeon, Tae Yeon, Kim, Kyunga, Kim, Yu Jin, Yoo, So-Young, Kim, Ji Hye, Chang, Yun Sil, Lee, Sanghoon, Seo, Jeong-Meen, Moon, Sung-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003522/
https://www.ncbi.nlm.nih.gov/pubmed/36902593
http://dx.doi.org/10.3390/jcm12051805
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author Kim, Myoung Kyoung
Jeon, Tae Yeon
Kim, Kyunga
Kim, Yu Jin
Yoo, So-Young
Kim, Ji Hye
Chang, Yun Sil
Lee, Sanghoon
Seo, Jeong-Meen
Moon, Sung-Hoon
author_facet Kim, Myoung Kyoung
Jeon, Tae Yeon
Kim, Kyunga
Kim, Yu Jin
Yoo, So-Young
Kim, Ji Hye
Chang, Yun Sil
Lee, Sanghoon
Seo, Jeong-Meen
Moon, Sung-Hoon
author_sort Kim, Myoung Kyoung
collection PubMed
description Objectives: To investigate the clinical outcomes of ultrasound (US)-detected perforated necrotizing enterocolitis (NEC) without radiographic pneumoperitoneum in very preterm infants. Methods: In this single-center retrospective study, very preterm infants who underwent a laparotomy for perforated NEC during their neonatal intensive care unit stay were classified into two groups according to the absence or presence of pneumoperitoneum on radiographs (the case versus the control groups). The primary outcome was death before discharge, and the secondary outcomes included major morbidities and body weight at 36 weeks postmenstrual age (PMA). Results: Of the 57 infants with perforated NEC, 12 (21%) had no pneumoperitoneum on the radiographs and were diagnosed with perforated NEC on the US. In the multivariable analyses, the primary outcome of death before discharge was significantly lower in infants with perforated NEC without radiographic pneumoperitoneum than in those with perforated NEC and radiographic pneumoperitoneum (8% [1/12] vs. 44% [20/45]; adjusted odds ratio [OR], 0.02; 95% confidence interval [CI], 0.00–0.61; p = 0.025). The secondary outcomes (short bowel syndrome, total parenteral nutrition dependence for 3 months or more, the length of their hospital stay, a bowel stricture requiring surgery, sepsis after the laparotomy, acute kidney injury after the laparotomy, and body weight at 36 weeks PMA) did not differ significantly between the two groups. Conclusions: Very preterm infants with US-detected perforated NEC without radiographic pneumoperitoneum had a lower risk of death before discharge than those with perforated NEC and radiographic pneumoperitoneum. Bowel USs may have a potential role in surgical decision-making in infants with advanced NEC.
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spelling pubmed-100035222023-03-11 Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants Kim, Myoung Kyoung Jeon, Tae Yeon Kim, Kyunga Kim, Yu Jin Yoo, So-Young Kim, Ji Hye Chang, Yun Sil Lee, Sanghoon Seo, Jeong-Meen Moon, Sung-Hoon J Clin Med Article Objectives: To investigate the clinical outcomes of ultrasound (US)-detected perforated necrotizing enterocolitis (NEC) without radiographic pneumoperitoneum in very preterm infants. Methods: In this single-center retrospective study, very preterm infants who underwent a laparotomy for perforated NEC during their neonatal intensive care unit stay were classified into two groups according to the absence or presence of pneumoperitoneum on radiographs (the case versus the control groups). The primary outcome was death before discharge, and the secondary outcomes included major morbidities and body weight at 36 weeks postmenstrual age (PMA). Results: Of the 57 infants with perforated NEC, 12 (21%) had no pneumoperitoneum on the radiographs and were diagnosed with perforated NEC on the US. In the multivariable analyses, the primary outcome of death before discharge was significantly lower in infants with perforated NEC without radiographic pneumoperitoneum than in those with perforated NEC and radiographic pneumoperitoneum (8% [1/12] vs. 44% [20/45]; adjusted odds ratio [OR], 0.02; 95% confidence interval [CI], 0.00–0.61; p = 0.025). The secondary outcomes (short bowel syndrome, total parenteral nutrition dependence for 3 months or more, the length of their hospital stay, a bowel stricture requiring surgery, sepsis after the laparotomy, acute kidney injury after the laparotomy, and body weight at 36 weeks PMA) did not differ significantly between the two groups. Conclusions: Very preterm infants with US-detected perforated NEC without radiographic pneumoperitoneum had a lower risk of death before discharge than those with perforated NEC and radiographic pneumoperitoneum. Bowel USs may have a potential role in surgical decision-making in infants with advanced NEC. MDPI 2023-02-23 /pmc/articles/PMC10003522/ /pubmed/36902593 http://dx.doi.org/10.3390/jcm12051805 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Myoung Kyoung
Jeon, Tae Yeon
Kim, Kyunga
Kim, Yu Jin
Yoo, So-Young
Kim, Ji Hye
Chang, Yun Sil
Lee, Sanghoon
Seo, Jeong-Meen
Moon, Sung-Hoon
Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title_full Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title_fullStr Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title_full_unstemmed Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title_short Clinical Outcome of Ultrasound-Detected Perforated Necrotizing Enterocolitis without Radiographic Pneumoperitoneum in Very Preterm Infants
title_sort clinical outcome of ultrasound-detected perforated necrotizing enterocolitis without radiographic pneumoperitoneum in very preterm infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003522/
https://www.ncbi.nlm.nih.gov/pubmed/36902593
http://dx.doi.org/10.3390/jcm12051805
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