Necrotizing enterocolitis and congenital heart disease: differences in management and prognosis.

R Mena Marcos, G Guillén Burrieza, A Castrillo Arias, S López Fernández, M Martos Rodríguez, A Montaner Ramón, A Creus, M G López Paredes, J A Molino Gahete
{"title":"Necrotizing enterocolitis and congenital heart disease: differences in management and prognosis.","authors":"R Mena Marcos, G Guillén Burrieza, A Castrillo Arias, S López Fernández, M Martos Rodríguez, A Montaner Ramón, A Creus, M G López Paredes, J A Molino Gahete","doi":"10.54847/cp.2024.04.11","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Necrotizing enterocolitis (NEC) is a main cause of neonatal morbimortality. Gut prematurity and ischemia-reperfusion injury contribute to NEC and characterize two different scenarios: prematurity and congenital cardiopathy (CC). Our aim is to investigate whether CC worsens NEC gastrointestinal and general prognosis.</p><p><strong>Materials and methods: </strong>NEC episodes from 2015-2023 were reviewed and classified into CC and non-CC. Patients with focal intestinal perforation were excluded. Data regarding NEC debut and management, surgical timing, intestinal segment involved and short-term outcomes were compared.</p><p><strong>Results: </strong>Out of 205 neonates, 15 were excluded for unavailable records or uncertain diagnosis. 190 cases were included, 59 with CC. Comparing CC and non-CC, no significant differences were found in weight or age at diagnosis, or NEC stage. Hemodynamic (HD) shock [38.98% vs 24.43% (p <  0.05)] and need for vasoactive support at debut were more frequent in CC patients [44.07% vs 23.66% (p < 0.05)]. No differences were found regarding need for surgery at debut, length of resected intestine or segment affected or days on parenteral nutrition. CC conditioned longer hospital stay [110.8 ± 68.4 days vs 68.4 ± 44.6 (p <  0.05)] and higher mortality [30.5 vs 11.5 (p <  0.05)].</p><p><strong>Conclusions: </strong>NEC in CC patients presents more HD instability at debut and worse global prognosis, probably due to inherent cardiovascular compromise, but need for surgery, type of intestinal involvement and short-term outcomes are similar to non-CC NEC.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.54847/cp.2024.04.11","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: Necrotizing enterocolitis (NEC) is a main cause of neonatal morbimortality. Gut prematurity and ischemia-reperfusion injury contribute to NEC and characterize two different scenarios: prematurity and congenital cardiopathy (CC). Our aim is to investigate whether CC worsens NEC gastrointestinal and general prognosis.

Materials and methods: NEC episodes from 2015-2023 were reviewed and classified into CC and non-CC. Patients with focal intestinal perforation were excluded. Data regarding NEC debut and management, surgical timing, intestinal segment involved and short-term outcomes were compared.

Results: Out of 205 neonates, 15 were excluded for unavailable records or uncertain diagnosis. 190 cases were included, 59 with CC. Comparing CC and non-CC, no significant differences were found in weight or age at diagnosis, or NEC stage. Hemodynamic (HD) shock [38.98% vs 24.43% (p <  0.05)] and need for vasoactive support at debut were more frequent in CC patients [44.07% vs 23.66% (p < 0.05)]. No differences were found regarding need for surgery at debut, length of resected intestine or segment affected or days on parenteral nutrition. CC conditioned longer hospital stay [110.8 ± 68.4 days vs 68.4 ± 44.6 (p <  0.05)] and higher mortality [30.5 vs 11.5 (p <  0.05)].

Conclusions: NEC in CC patients presents more HD instability at debut and worse global prognosis, probably due to inherent cardiovascular compromise, but need for surgery, type of intestinal involvement and short-term outcomes are similar to non-CC NEC.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
坏死性小肠结肠炎和先天性心脏病:管理和预后的差异。
目的:坏死性小肠结肠炎(NEC坏死性小肠结肠炎(NEC)是新生儿死亡的主要原因。肠道早产和缺血再灌注损伤是导致 NEC 的原因,也是两种不同情况的特征:早产和先天性心脏病(CC)。我们的目的是研究CC是否会恶化NEC的胃肠道和总体预后:回顾2015-2023年的NEC病例,并将其分为CC和非CC。排除局灶性肠穿孔患者。比较了有关 NEC 首次发病和处理、手术时机、涉及的肠段和短期预后的数据:结果:在 205 例新生儿中,有 15 例因无法获得记录或诊断不明确而被排除。共纳入 190 例,其中 59 例为 CC。CC 和非 CC 新生儿在体重、诊断时的年龄或 NEC 分期方面没有明显差异。血流动力学(HD)休克[38.98% vs 24.43% (p < 0.05)]和首次就诊时需要血管活性支持在CC患者中更为常见[44.07% vs 23.66% (p 结论:CC患者的血流动力学休克和首次就诊时需要血管活性支持在CC患者中更为常见:CC患者的NEC在首发时表现出更多的高密度脂蛋白血症不稳定性和更差的总体预后,这可能是由于固有的心血管损害,但手术需求、肠道受累类型和短期预后与非CC NEC相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Evaluation of quality of life and satisfaction in patients undergoing laparoscopic Mitrofanoff procedure. How far do we want to go? Innovation and challenges: minimally invasive surgery training in Latin America. Necrotizing enterocolitis and congenital heart disease: differences in management and prognosis. Optimizing pediatric laparoscopic cholecystectomy: trocar reduction with percutaneous gallblader traction.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1