Cargando…
Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis
The importance for mortality and morbidity of an in-house pediatric surgery unit for premature infants with necrotizing enterocolitis (NEC) remains undefined. Data on 389 consecutive very low birth weight infants with a birth weight <1250 g admitted between 2009 and 2014 was retrospectively analy...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258105/ https://www.ncbi.nlm.nih.gov/pubmed/30539013 http://dx.doi.org/10.1155/2018/5042707 |
_version_ | 1783374440615116800 |
---|---|
author | Zamrik, Sonja Giachero, Federica Heldmann, Michael Hensel, Kai O. Wirth, Stefan Jenke, Andreas C. |
author_facet | Zamrik, Sonja Giachero, Federica Heldmann, Michael Hensel, Kai O. Wirth, Stefan Jenke, Andreas C. |
author_sort | Zamrik, Sonja |
collection | PubMed |
description | The importance for mortality and morbidity of an in-house pediatric surgery unit for premature infants with necrotizing enterocolitis (NEC) remains undefined. Data on 389 consecutive very low birth weight infants with a birth weight <1250 g admitted between 2009 and 2014 was retrospectively analyzed in two almost identical neonatal intensive care units. Epidemiological data (n=172 and n=217, respectively) were comparable. Incidence of NEC stage II+ was significantly higher in center 1 (15.1 versus 5.5%, n=18 versus 6). This correlated with a significantly lower rate of exclusive human milk feeding compared to center 2 (24.2 versus 59.3%). Probiotic treatment did not differ. Importantly, in case of surgery the length of removed intestine (49.9 versus 19.5 cm) and the rate of severe short-bowel syndrome (38.9 versus 0 %) were significantly higher in center 1 (no in-house pediatric surgery). Furthermore, long-term morbidity assessment revealed more impaired motoric (-4.2 versus -2.2 months, p=0.21) and psychologic (-4.3 versus -1.6 months, p=0.09) development in center 1. Mortality was similar in both centers. Conclusions. Short- and possibly also long-term morbidity of NEC is clearly associated with the presence of an on-site pediatric surgery unit. Enteral nutrition with human milk seems to be a strong protective factor against NEC. |
format | Online Article Text |
id | pubmed-6258105 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-62581052018-12-11 Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis Zamrik, Sonja Giachero, Federica Heldmann, Michael Hensel, Kai O. Wirth, Stefan Jenke, Andreas C. Biomed Res Int Research Article The importance for mortality and morbidity of an in-house pediatric surgery unit for premature infants with necrotizing enterocolitis (NEC) remains undefined. Data on 389 consecutive very low birth weight infants with a birth weight <1250 g admitted between 2009 and 2014 was retrospectively analyzed in two almost identical neonatal intensive care units. Epidemiological data (n=172 and n=217, respectively) were comparable. Incidence of NEC stage II+ was significantly higher in center 1 (15.1 versus 5.5%, n=18 versus 6). This correlated with a significantly lower rate of exclusive human milk feeding compared to center 2 (24.2 versus 59.3%). Probiotic treatment did not differ. Importantly, in case of surgery the length of removed intestine (49.9 versus 19.5 cm) and the rate of severe short-bowel syndrome (38.9 versus 0 %) were significantly higher in center 1 (no in-house pediatric surgery). Furthermore, long-term morbidity assessment revealed more impaired motoric (-4.2 versus -2.2 months, p=0.21) and psychologic (-4.3 versus -1.6 months, p=0.09) development in center 1. Mortality was similar in both centers. Conclusions. Short- and possibly also long-term morbidity of NEC is clearly associated with the presence of an on-site pediatric surgery unit. Enteral nutrition with human milk seems to be a strong protective factor against NEC. Hindawi 2018-11-13 /pmc/articles/PMC6258105/ /pubmed/30539013 http://dx.doi.org/10.1155/2018/5042707 Text en Copyright © 2018 Sonja Zamrik et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Zamrik, Sonja Giachero, Federica Heldmann, Michael Hensel, Kai O. Wirth, Stefan Jenke, Andreas C. Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title_full | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title_fullStr | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title_full_unstemmed | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title_short | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
title_sort | impact of an in-house pediatric surgery unit and human milk centered enteral nutrition on necrotizing enterocolitis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258105/ https://www.ncbi.nlm.nih.gov/pubmed/30539013 http://dx.doi.org/10.1155/2018/5042707 |
work_keys_str_mv | AT zamriksonja impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis AT giacherofederica impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis AT heldmannmichael impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis AT henselkaio impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis AT wirthstefan impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis AT jenkeandreasc impactofaninhousepediatricsurgeryunitandhumanmilkcenteredenteralnutritiononnecrotizingenterocolitis |