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Necrotizing enterocolitis in preterm infant

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https://www.readbyqxmd.com/read/28806296/the-risk-of-necrotizing-enterocolitis-differs-among-preterm-pigs-fed-formulas-with-either-lactose-or-maltodextrin
#1
Randal K Buddington, Samantha L Davis, Karyl K Buddington
OBJECTIVES: When breast milk is unavailable for preterm infants, formulas are needed that won't increase the risk of necrotizing enterocolitis (NEC). Adding novel ingredients to formula to reduce NEC has not been effective clinically. Instead, we tested the prediction that NEC can be reduced by removing the maltodextrin now included in preterm formulas. METHODS: The preterm pig model of spontaneous NEC was used to evaluate growth, health, and intestinal responses to 6-7 days of feeding formulas that were identical except for the source of carbohydrate; either 100% lactose or maltodextrin; colostrum was used as the control...
August 11, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28796951/bifidobacterium-breve-m-16v-as-a-probiotic-for-preterm-infants-a-strain-specific-systematic-review
#2
Gayatri Athalye-Jape, Shripada Rao, Karen Simmer, Sanjay Patole
INTRODUCTION: Bifidobacterium breve M-16V has been used as a probiotic in preterm infants. Probiotic strain-specific data are essential to guide clinical practice. OBJECTIVE: To assess effects of B breve M-16V in preterm neonates. DESIGN: A systematic review of randomized controlled trials (RCTs) and non-RCTs of B breve M-16V in preterm infants was conducted. Multiple databases, proceedings of Pediatric Academy Society, and other relevant conferences were searched in September 2016 and on January 5, 2017...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28774358/-clinical-effect-of-extensively-hydrolyzed-formula-in-preterm-infants-an-analysis-of-327-cases
#3
Wei He, Jia-Hua Pan
OBJECTIVE: To investigate the effect and safety of extensively hydrolyzed formula (EHF) in preterm infants. METHODS: A total of 692 preterm infants between January 2007 and December 2016 were enrolled as subjects. According to the feeding pattern, they were divided into EHF group (327 infants) and standard preterm formula (SPF) group (365 infants). A retrospective analysis was performed for their clinical data during hospitalization, including the incidence of feeding intolerance, time to establish full enteral feeding, time to first excretion of meconium, time to complete excretion of meconium, presence or absence of intestinal infection or neonatal necrotizing enterocolitis (NEC), serum albumin level within 3 weeks after admission, and time to the appearance of skin jaundice and its duration...
August 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28770467/candidate-gene-analysis-in-pathogenesis-of-surgically-and-non-surgically-treated-necrotizing-enterocolitis-in-preterm-infants
#4
Dawid Szpecht, Natalia Neumann-Klimasińska, Michał Błaszczyński, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Dorothy Cygan, Marta Szymankiewicz, Krzysztof Drews, Janusz Gadzinowski
Necrotizing enterocolitis (NEC) is one of the most severe and unpredictable complications of prematurity. There are two possible mechanisms involved in the pathogenesis of NEC: individual inflammatory response and impaired blood flow in mesenteric vessels with secondary ischemia of the intestine. The aim of this study was to evaluate the possible relationship between polymorphisms: Il-1β 3953C>T, Il-6 -174G>C and -596G>A, TNFα -308G>A, and 86 bp variable number tandem repeat polymorphism of interleukin-1 receptor antagonist (Il-1RN VNTR 86 bp) and three polymorphisms that may participate in arteries tension regulation and in consequence in intestine blood flow impairment: eNOS (894G>T and -786T>C) and END-1 (5665G>T) and NEC in 100 infants born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroids therapy, and without congenital abnormalities...
August 2, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28761416/neurological-consequences-of-systemic-inflammation-in-the-premature-neonate
#5
REVIEW
Aparna Patra, Hong Huang, John A Bauer, Peter J Giannone
Despite substantial progress in neonatal care over the past two decades leading to improved survival of extremely premature infants, extreme prematurity continues to be associated with long term neurodevelopmental impairments. Cerebral white matter injury is the predominant form of insult in preterm brain leading to adverse neurological consequences. Such brain injury pattern and unfavorable neurologic sequelae is commonly encountered in premature infants exposed to systemic inflammatory states such as clinical or culture proven sepsis with or without evidence of meningitis, prolonged mechanical ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and chorioamnionitis...
June 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28742738/necrotizing-enterocolitis-current-concepts-in-practice
#6
Alysia Agnoni, Christine Lazaros Amendola
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants and continues to be a major cause of morbidity and mortality. The incidence of NEC as well as mortality from the disease has persisted at unacceptably high levels for decades as current understanding of the cause remains incomplete. Identifying infants at risk and preventing NEC are mainstays of care. This article briefly examines disease presentation and treatment, identifies gaps in current understanding of disease pathology, and highlights new research that may lead to a decrease in the incidence of NEC in the future...
August 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#7
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28714327/elevated-levels-of-circulating-cell-free-dna-and-neutrophil-proteins-are-associated-with-neonatal-sepsis-and-necrotizing-enterocolitis-in-immature-mice-pigs-and-infants
#8
Duc Ninh Nguyen, Allan Stensballe, Jacqueline Cy Lai, Pingping Jiang, Anders Brunse, Yanqi Li, Jing Sun, Carina Mallard, Tom Skeath, Nicholas D Embleton, Janet E Berrington, Per T Sangild
Preterm infants are highly susceptible to late-onset sepsis (LOS) and necrotizing enterocolitis (NEC), but disease pathogenesis and specific diagnostic markers are lacking. Circulating cell-free DNA (cfDNA) and immune cell-derived proteins are involved in multiple immune diseases in adults but have not been investigated in preterm neonates. We explored the relation of circulating neutrophil-associated proteins and cfDNA to LOS and/or NEC. Using a clinically relevant preterm pig model of spontaneous LOS and NEC development, we investigated neutrophil-associated proteins and cfDNA in plasma, together with cytokines in gut tissues...
January 1, 2017: Innate Immunity
https://www.readbyqxmd.com/read/28709451/comparing-very-low-birth-weight-versus-very-low-gestation-cohort-methods-for-outcome-analysis-of-high-risk-preterm-infants
#9
Louise Im Koller-Smith, Prakesh S Shah, Xiang Y Ye, Gunnar Sjörs, Yueping A Wang, Sharon S W Chow, Brian A Darlow, Shoo K Lee, Stellan Håkanson, Kei Lui
BACKGROUND: Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. METHOD: Data from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation...
July 14, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28704816/short-versus-extended-duration-of-trophic-feeding-to-reduce-time-to-achieve-full-enteral-feeding-in-extremely-preterm-infants-an-observational-study
#10
Ariel A Salas, Nazia Kabani, Colm P Travers, Vivien Phillips, Namasivayam Ambalavanan, Wally A Carlo
BACKGROUND: Trophic feeding compared to no enteral feeding prevents atrophy of the gastrointestinal tract. However, the practice of extending the duration of trophic feeding often delays initiation of full enteral feeding in extremely preterm infants. We hypothesized that a short duration of trophic feeding (3 days or less) is associated with early initiation of full enteral feeding. METHODS: A total of 192 extremely preterm infants (23-28 weeks' gestation) born between 2013 and 2015 were included...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28696954/necrotizing-enterocolitis-current-concepts-in-practice
#11
Alysia Agnoni, Christine Lazaros Amendola
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants and continues to be a major cause of morbidity and mortality. The incidence of NEC as well as mortality from the disease has persisted at unacceptably high levels for decades as current understanding of the cause remains incomplete. Identifying infants at risk and preventing NEC are mainstays of care. This article briefly examines disease presentation and treatment, identifies gaps in current understanding of disease pathology, and highlights new research that may lead to a decrease in the incidence of NEC in the future...
July 10, 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28690615/impact-of-early-life-exposures-to-infections-antibiotics-and-vaccines-on-perinatal-and-long-term-health-and-disease
#12
REVIEW
Steven L Raymond, Jaimar C Rincon, James L Wynn, Lyle L Moldawer, Shawn D Larson
Essentially, all neonates are exposed to infections, antibiotics, or vaccines early in their lives. This is especially true for those neonates born underweight or premature. In contrast to septic adults and children who are at an increased risk for subsequent infections, exposure to infection during the neonatal period is not associated with an increased risk of subsequent infection and may be paradoxically associated with reductions in late-onset sepsis (LOS) in the most premature infants. Perinatal inflammation is also associated with a decreased incidence of asthma and atopy later in life...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28680875/echocardiographic-evaluation-of-patent-ductus-arteriosus-in-preterm-infants
#13
REVIEW
Romaine Arlettaz
Patent ductus arteriosus (PDA) is part of the typical morbidity profile of the preterm infant, with a high incidence of 80-90% in extremely low birth weight infants born before 26 weeks of gestation. Whereas spontaneous closure of the ductus arteriosus (DA) is likely in term infants, it is less so in preterm ones. PDA is associated with increased mortality and various comorbidities including cardiac failure, need for respiratory support, bronchopulmonary dysplasia, pulmonary or intracranial hemorrhage, and necrotizing enterocolitis; however, there is no proven causality between these morbidities and the presence of DA...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28659297/nutritional-strategies-and-gut-microbiota-composition-as-risk-factors-for-necrotizing-enterocolitis-in-very-preterm-infants
#14
Jean-Christophe Rozé, Pierre-Yves Ancel, Patricia Lepage, Laetitia Martin-Marchand, Ziad Al Nabhani, Johanne Delannoy, Jean-Charles Picaud, Alexandre Lapillonne, Julio Aires, Mélanie Durox, Dominique Darmaun, Josef Neu, Marie-José Butel
Background: The pathophysiology of necrotizing enterocolitis (NEC) remains poorly understood.Objective: We assessed the relation between feeding strategies, intestinal microbiota composition, and the development of NEC.Design: We performed a prospective nationwide population-based study, EPIPAGE 2 (Etude Epidémiologique sur les Petits Ages Gestationnels), including preterm infants born at <32 wk of gestation in France in 2011. From individual characteristics observed during the first week of life, we calculated a propensity score for the risk of NEC (Bell's stage 2 or 3) after day 7 of life...
June 28, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28658720/enteral-lactoferrin-supplementation-for-prevention-of-sepsis-and-necrotizing-enterocolitis-in-preterm-infants
#15
REVIEW
Mohan Pammi, Gautham Suresh
BACKGROUND: Lactoferrin, a normal component of human colostrum and milk, can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES: Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1. To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and/or NEC on duration of positive-pressure ventilation, development of chronic lung disease (CLD) or periventricular leukomalacia (PVL), length of hospital stay to discharge among survivors, and adverse neurological outcomes at two years of age or later2...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28651469/morbidities-associated-with-patent-ductus-arteriosus-in-preterm-infants-nationwide-cohort-study
#16
Pia Härkin, Riitta Marttila, Tytti Pokka, Timo Saarela, Mikko Hallman
PURPOSE: To evaluate the predictive factors for the development of haemodynamically significant patent ductus arteriosus (PDA) in preterm infants and to study the morbidities associated with the treatment of PDA during the first hospitalization. MATERIALS AND METHODS: Data were collected from the Finnish national register of preterm infants (<32 gestational weeks) born in 2005-2013. In total, 3668 infants were included. Morbidities during the first hospitalization were analysed and compared between infants who received treatments for the closure of PDA (n = 1132) and infants who received no treatment for PDA (n = 2536)...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28647272/outcomes-of-preterm-infants-following-discussions-about-withdrawal-or-withholding-of-life-support
#17
Jennifer James, David Munson, Sara B DeMauro, John C Langer, April R Dworetz, Girija Natarajan, Margarita Bidegain, Christine A Fortney, Ruth Seabrook, Betty R Vohr, Jon E Tyson, Edward F Bell, Brenda B Poindexter, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Barbara J Stoll, Haresh Kirpalani
OBJECTIVES: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes. STUDY DESIGN: This retrospective review included registry data from 18 centers of the National Institute of Child Health and Human Development Neonatal Research Network. Infants born at 22-28 weeks of gestation who survived >12 hours during 2011-2013 were included...
June 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28644358/early-empiric-antibiotic-use-is-associated-with-delayed-feeding-tolerance-in-preterm-infants-a-retrospective-analysis
#18
Francisco E Martinez, Walusa A G Ferri, Clea R Leone, Maria Fernanda Branco de Almeida, Ruth Guinsburg, Jucille do Amaral Meneses, Marynéa Silva do Vale, Sergio Tadeu Martins Marba, Werther Brunow de Carvalho, Ligia Maria Suppo de Souza Rugolo, José Maria de Andrade Lopes, Manoel A Ribeiro, Renato S Procianoy, José Luiz Muniz Bandeira Duarte, Maria Cândida Ferrarez Bouzada, Daniela Marques de Lima Mota Ferreira, Navantino Alves Filho, Edna Maria de Albuquerque Diniz, Dulce Maria Toledo Zanardi, Daniela Testoni, Cristina Nunes Dos Santos, Maria Rafaela Conde Gomzález, Paulyne Stadler Venzon, Jaques Belik
The causative factors of neonatal feeding intolerance are poorly understood, but potentially related to clinical practices such as empiric antibiotic usage. The objective of this study was to evaluate whether early empiric antibiotic exposure negatively affects preterm infants' enteral feeding tolerance. Data from infants without risk factors for sepsis, 500 to 1499 g birth weight and 24 to 34 weeks gestational age were analyzed. The primary outcomes were the empiric antibiotic exposure effects on the infants' total parenteral nutrition usage duration and prevalence of necrotizing enterocolitis (NEC)...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28633098/high-prevalence-of-cytomegalovirus-infection-in-surgical-intestinal-specimens-from-infants-with-necrotizing-enterocolitis-and-spontaneous-intestinal-perforation-a-retrospective-observational-study
#19
Soley Omarsdottir, Margret Agnarsdottir, Charlotte Casper, Abiel Orrego, Mireille Vanpée, Afsar Rahbar, Cecilia Söderberg-Nauclér
BACKGROUND: Necrotizing enterocolitis (NEC) is a severe, often fatal gastrointestinal emergency that predominantly affects preterm infants, and there is evidence that neonatal cytomegalovirus (CMV) infection may in some cases contribute to its pathogenesis. OBJECTIVES: This study aimed to evaluate the prevalence of CMV in infants with NEC. STUDY DESIGN: Seventy intestinal specimens from 61 infants with NEC, spontaneous intestinal perforation (SIP), or related surgical complications were collected at Karolinska University Hospital and Uppsala University Hospital, Sweden...
June 3, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28625498/the-impact-of-routine-evaluation-of-gastric-residual-volumes-on-the-time-to-achieve-full-enteral-feeding-in-preterm-infants
#20
Arieh Riskin, Keren Cohen, Amir Kugelman, Arina Toropine, Waseem Said, David Bader
OBJECTIVE: To evaluate the time to full enteral feedings in preterm infants after a practice change from routine evaluation of gastric residual volume before each feeding to selective evaluation of gastric residual volume , and to evaluate the impact of this change on the incidence of necrotizing enterocolitis (NEC). STUDY DESIGN: Data were collected on all gavage-fed infants born at ≤34 weeks gestational age (GA) for 2 years before (n = 239) and 2 years after the change (n = 233)...
June 15, 2017: Journal of Pediatrics
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