Document Detail

Necrotizing enterocolitis: factors affecting mortality in 101 surgical cases.
MedLine Citation:
PMID:  6484808     Owner:  NLM     Status:  MEDLINE    
One hundred one infants requiring operative treatment for necrotizing enterocolitis were evaluated for prenatal, perinatal, therapeutic, clinical, laboratory, radiographic, and operative factors as they relate to mortality. Infants less than 28 weeks gestation and those with birth weight less than 1500 gm had an increased mortality rate. The use of umbilical arterial catheters, high-density premature formulas, and aminophylline (for apnea) had an adverse effect on survival. Persistent acidosis, oliguria, and abdominal wall erythema resulted in a significantly worse outcome. The presence of portal vein air on abdominal radiograph was associated with a 71% mortality rate. The survival rate in infants with localized involvement was 70%. Thirty-eight percent of patients had extensive bowel involvement and a greater than 95% mortality rate. Avoidance of enteral feedings, cautious use of umbilical artery catheters, and judicious application of pharmacologic agents in infants at risk for necrotizing enterocolitis is of importance with regard to prevention. While medical management is feasible in some cases, persistent acidosis, oliguria, abdominal wall erythema, and portal vein air are associated with advanced disease. Infants with these risk factors should be candidates for prompt operative intervention.
D Cikrit; J Mastandrea; K W West; R L Schreiner; J L Grosfeld
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  96     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1984 Oct 
Date Detail:
Created Date:  1984-11-02     Completed Date:  1984-11-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  648-55     Citation Subset:  AIM; IM    
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MeSH Terms
Aminophylline / adverse effects
Birth Weight
Catheterization / adverse effects
Enterocolitis, Pseudomembranous / etiology,  mortality*,  surgery
Gestational Age
Infant Food
Infant, Newborn
Intestinal Perforation / complications
Intestines / blood supply,  radiography
Ischemia / complications
Portal Vein / radiography
Thrombocytopenia / complications
Umbilical Arteries
Reg. No./Substance:

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