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
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| creator | Wirth, Stefan Hensel, Kai O. Heldmann, Michael Giachero, Federica Zamrik, Sonja Jenke, Andreas |
| 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 |
| doi_str_mv | 10.1155/2018/5042707 |
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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.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2018/5042707</identifier><identifier>PMID: 30539013</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Age ; Birth weight ; Breast milk ; Children ; Comparative analysis ; Cooperation ; Enteral nutrition ; Enterocolitis ; Enterocolitis, Neonatal necrotizing ; Enterocolitis, Pseudomembranous ; Epidemiology ; Gastrointestinal agents ; Gastrointestinal diseases ; Health aspects ; Hospitals ; Infants ; Infants (Premature) ; Intensive care units ; Intestine ; Low birth weight ; Medicine ; Milk ; Morbidity ; Mortality ; Necrosis ; Necrotizing enterocolitis ; Neonatal intensive care ; Neonates ; Newborn babies ; Nutrition ; Onsite ; Pediatrics ; Probiotics ; Surgeons ; Surgery ; Systematic review ; Weight</subject><ispartof>BioMed research international, 2018-01, Vol.2018 (2018), p.1-6</ispartof><rights>Copyright © 2018 Sonja Zamrik et al.</rights><rights>COPYRIGHT 2018 John Wiley & Sons, Inc.</rights><rights>Copyright © 2018 Sonja Zamrik et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2018 Sonja Zamrik et al. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-e6c3af43c429a88894f668188eed0b84cf9976d8997295811b43d85e995a064c3</citedby><cites>FETCH-LOGICAL-c499t-e6c3af43c429a88894f668188eed0b84cf9976d8997295811b43d85e995a064c3</cites><orcidid>0000-0002-4008-7185 ; 0000-0001-5826-6133</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258105/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258105/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30539013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Muraskas, Jonathan</contributor><contributor>Jonathan Muraskas</contributor><creatorcontrib>Wirth, Stefan</creatorcontrib><creatorcontrib>Hensel, Kai O.</creatorcontrib><creatorcontrib>Heldmann, Michael</creatorcontrib><creatorcontrib>Giachero, Federica</creatorcontrib><creatorcontrib>Zamrik, Sonja</creatorcontrib><creatorcontrib>Jenke, Andreas</creatorcontrib><title>Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><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.</description><subject>Age</subject><subject>Birth weight</subject><subject>Breast milk</subject><subject>Children</subject><subject>Comparative analysis</subject><subject>Cooperation</subject><subject>Enteral nutrition</subject><subject>Enterocolitis</subject><subject>Enterocolitis, Neonatal necrotizing</subject><subject>Enterocolitis, Pseudomembranous</subject><subject>Epidemiology</subject><subject>Gastrointestinal agents</subject><subject>Gastrointestinal diseases</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Infants</subject><subject>Infants (Premature)</subject><subject>Intensive care units</subject><subject>Intestine</subject><subject>Low birth weight</subject><subject>Medicine</subject><subject>Milk</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Necrosis</subject><subject>Necrotizing enterocolitis</subject><subject>Neonatal intensive care</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Nutrition</subject><subject>Onsite</subject><subject>Pediatrics</subject><subject>Probiotics</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Systematic 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Enteral Nutrition on Necrotizing Enterocolitis</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>2018</volume><issue>2018</issue><spage>1</spage><epage>6</epage><pages>1-6</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>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.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>30539013</pmid><doi>10.1155/2018/5042707</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4008-7185</orcidid><orcidid>https://orcid.org/0000-0001-5826-6133</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Birth weight Breast milk Children Comparative analysis Cooperation Enteral nutrition Enterocolitis Enterocolitis, Neonatal necrotizing Enterocolitis, Pseudomembranous Epidemiology Gastrointestinal agents Gastrointestinal diseases Health aspects Hospitals Infants Infants (Premature) Intensive care units Intestine Low birth weight Medicine Milk Morbidity Mortality Necrosis Necrotizing enterocolitis Neonatal intensive care Neonates Newborn babies Nutrition Onsite Pediatrics Probiotics Surgeons Surgery Systematic review Weight |
| title | Impact of an In-House Pediatric Surgery Unit and Human Milk Centered Enteral Nutrition on Necrotizing Enterocolitis |
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