Necrotizing Enterocolitis in Newborns: Diagnosis, Etiology, Management, Prevention, Complications and their Relation to Future Sport Performance

Zofia Uszok, Michał Łepik, Krzysztof Rosiak, Kacper Płeska, Kacper Reguła, Kamil Waloch, Joanna Wojtania, Szymon Piaszczyński, Bartłomiej Szymański, Andrzej Czajka
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Abstract

Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition that primarily affects premature infants, although it can also occur in full-term infants. It is characterized by inflammation and injury of the intestinal tissue, which can progress to necrosis and perforation of the bowel. NEC is a leading cause of morbidity and mortality in neonatal intensive care units (NICUs), particularly among very low birth weight infants. Diagnosis of NEC is based on clinical signs and symptoms, radiographic findings, and laboratory tests. Management of NEC involves a multidisciplinary approach, including supportive care, medical therapy, and surgical intervention when necessary. Supportive care includes bowel rest, intravenous fluids, and nutritional support. Medical therapy may include antibiotics, gastric decompression, and parenteral nutrition. Surgical intervention may be required for infants with intestinal perforation, severe NEC, or complications such as intestinal stricture or short bowel syndrome. This condition and its complications may carry consequences for life and especially sport performance in the child’s future. Strategies for preventing NEC include promoting breastfeeding, avoiding unnecessary antibiotic exposure, minimizing enteral feeding interruptions, practicing strict infection control measures, and implementing protocols for gradual feeding advancement in premature infants. Overall, NEC is a complex and multifactorial disease that poses significant challenges in neonatal care. Early recognition, prompt intervention, and comprehensive management are essential for optimizing outcomes for affected infants. Further research is needed to better understand the pathophysiology of NEC and to develop more effective prevention and treatment strategies.
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新生儿坏死性小肠结肠炎:诊断、病因、处理、预防、并发症及其与未来运动表现的关系
坏死性小肠结肠炎(NEC)是一种严重的胃肠道疾病,主要影响早产儿,但也可能发生在足月儿身上。其特点是肠道组织发炎和损伤,可发展为肠道坏死和穿孔。NEC 是新生儿重症监护病房(NICU)发病率和死亡率的主要原因,尤其是在出生体重极低的婴儿中。NEC 的诊断基于临床症状和体征、影像学检查结果以及实验室检查。NEC 的治疗涉及多学科方法,包括支持性护理、药物治疗和必要时的手术干预。支持性护理包括肠道休息、静脉输液和营养支持。药物治疗可包括抗生素、胃减压和肠外营养。如果婴儿出现肠穿孔、严重的 NEC 或肠道狭窄或短肠综合症等并发症,则可能需要手术治疗。这种情况及其并发症可能会影响孩子的生活,尤其是将来的运动表现。预防 NEC 的策略包括促进母乳喂养、避免不必要的抗生素接触、尽量减少肠内喂养中断、采取严格的感染控制措施以及对早产儿实施循序渐进的喂养方案。总之,NEC 是一种复杂的多因素疾病,给新生儿护理带来了巨大挑战。早期识别、及时干预和综合管理对于优化受影响婴儿的预后至关重要。要更好地了解 NEC 的病理生理学,并制定更有效的预防和治疗策略,还需要进一步的研究。
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