Primary peritoneal drainage for increasing ventilatory requirements in critically ill neonates with necrotizing enterocolitis

Background/Purpose: Primary peritoneal drainage (PPD) is an established therapy for premature neonates with necrotizing enterocolitis (NEC) and free intraperitoneal air. This study seeks to evaluate the efficacy of PPD in ill premature neonates with severe abdominal distension and increasing ventilatory requirements without free intraperitoneal air. Methods: Eleven neonates (gestational age, 27 ± 0.59 weeks; age, 25 ± 4.3 days; birth weight, 862 ± 67 g) with NEC underwent bedside PPD under local anesthesia for rapid clinical deterioration characterized by severe abdominal distension and increasing ventilatory requirements. None showed radiographic evidence of free intraperitoneal air. Mean airway pressure (MAP) and oxygenation-index (OI) were analyzed 24 hours before, immediately before and 24 hours after surgery. The patients were followed up to discharge from hospital. Statistical analyses were performed using analysis of variance (ANOVA) for repeated measures. Results: Mean airway pressure (MAP) showed a significant difference (P