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Time to reintroduction of feeding in infants with nonsurgical necrotizing enterocolitis.
Arbra, Chase A; Oprisan, Andra; Wilson, Dulaney A; Ryan, Rita M; Lesher, Aaron P.
Afiliación
  • Arbra CA; Department of Surgery, Medical University of South Carolina, Charleston, SC.
  • Oprisan A; Department of Surgery, Medical University of South Carolina, Charleston, SC.
  • Wilson DA; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
  • Ryan RM; Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
  • Lesher AP; Department of Surgery, Medical University of South Carolina, Charleston, SC. Electronic address: leshera@musc.edu.
J Pediatr Surg ; 53(6): 1187-1191, 2018 Jun.
Article en En | MEDLINE | ID: mdl-29622398
BACKGROUND: For infants with necrotizing enterocolitis (NEC) treated nonoperatively, no consensus exists on the optimal fasting period prior to reintroducing feeds after NEC. We report our experience with early (<7days) and late (≥7days) refeeding in this population. METHODS: A chart review of infants with NEC born between 2006 and 2016 was performed. Data elements include demographics, comorbidities, day of diagnosis, Bell's stage, recurrence, strictures, length of stay and mortality, and were grouped into early and late refeeding. T-tests were used for means and chi-squared tests for distribution of proportions. Linear and logistic regressions were used to further evaluate the association of length of stay, stricture, recurrence, and death with time to refeeding. RESULTS: Of 228 NEC patients, 149(65%) were treated nonoperatively (Bell Stages I, IIA, IIB, IIIA). Eleven patients were excluded owing to never restarting feeds, largely secondary to early death. The early (n=40) and late refeeding (n=98) groups were not significantly different with regard to mean gestational age at birth, race, birth weight, day of life at NEC diagnosis, or cardiac disease. NEC Stage was significantly different (p<0.001). The late group had significantly more Stage IIB patients (p=.02), and the early group had more stage I patients (p=<0.01). After adjusting for Bell's stage, the odds of NEC recurrence, death, and the composite outcome of recurrence or stricture or death were not significantly different between early and late groups. CONCLUSIONS: No standardized guidelines exist for restarting enteral nutrition following medical NEC. In patients managed nonoperatively, early reintroduction of feeding was not significantly associated with increased NEC recurrence, mortality, or stricture. LEVEL OF EVIDENCE: Treatment Study - Level III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nutrición Enteral / Enterocolitis Necrotizante Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Surg Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nutrición Enteral / Enterocolitis Necrotizante Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Surg Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos