Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain
Objectives: To describe preventive, diagnostic and therapeutic strategies regarding necrotising enterocolitis in Spain and to identify the strengths, areas of further improvement, and future research lines. Methods: Two questionnaires on the management of preterm infants less than 32 weeks, at risk...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | Spanish |
| Published: |
Elsevier
2020-09-01
|
| Series: | Anales de Pediatría (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2341287920301368 |
| _version_ | 1818639874056519680 |
|---|---|
| author | Carlos Zozaya Alejandro Avila-Alvarez Iván Somoza Argibay Fermín García-Muñoz Rodrigo Niki Oikonomopoulou José Luis Encinas Miguel Saenz de Pipaón María Luz Couce |
| author_facet | Carlos Zozaya Alejandro Avila-Alvarez Iván Somoza Argibay Fermín García-Muñoz Rodrigo Niki Oikonomopoulou José Luis Encinas Miguel Saenz de Pipaón María Luz Couce |
| author_sort | Carlos Zozaya |
| collection | DOAJ |
| description | Objectives: To describe preventive, diagnostic and therapeutic strategies regarding necrotising enterocolitis in Spain and to identify the strengths, areas of further improvement, and future research lines. Methods: Two questionnaires on the management of preterm infants less than 32 weeks, at risk of, or with diagnosed necrotising enterocolitis, were distributed among selected representatives of the surgeons and neonatologists of the Spanish Neonatal Network (SEN1500) participant hospitals with a Paediatric Surgery Department. Results: Percentage of response was 77.1% of contacted surgeons and 88.6% of neonatologists. There is a written protocol on the diagnosis and medical management of necrotising enterocolitis in 52% of the hospitals, and as regards surgical treatment in 33%. There is wide access to donor bank milk and to staff dedicated to breastfeeding promotion (87%). On the contrary, only 52% of the centres perform delayed cord clamping, and probiotics are used in just 23%. The use of abdominal ultrasound is increasing. There are no large differences as regards duration of antibiotic use and bowel rest, whereas there was as regards antibiotic selection, surgical indication, and type of intervention. Conclusions: As regards prevention, delayed cord clamping and extended access to donor milk are two possible aspects of further improvement. The observed discrepancies noted in diagnostic and therapeutic aspects are common in precisely the areas where evidence in the literature is weakest. Resumen: Objetivo: Describir la prevención, diagnóstico y tratamiento de la enterocolitis necrosante en hospitales españoles e identificar puntos fuertes, áreas de mejora y líneas de investigación pendientes. Métodos: Se realizaron 2 encuestas sobre manejo de pacientes en riesgo o diagnóstico de enterocolitis necrosante en recién nacidos pretérmino menores de 32 semanas, distribuidas entre representantes de los cirujanos pediátricos y neonatólogos de los centros participantes en la red española SEN 1500 con Servicio de Cirugía Pediátrica. Resultados: El porcentaje de respuestas fue del 77.1% y del 88.6% entre los cirujanos y neonatólogos contactados, respectivamente. El 52% de los hospitales dispone de un protocolo de diagnóstico y manejo médico de la enterocolitis y el 33% uno sobre tratamiento quirúrgico. El acceso a leche de banco y disponer de personal dedicado a la promoción de la lactancia materna es común (87%), por el contrario, la ligadura tardía de cordón solo se realiza en el 52% de los centros y en un 23% se administran probióticos. La ecografía abdominal está cada vez más extendida. No hay grandes diferencias en cuanto a la duración de los antibióticos y del reposo intestinal, pero si en cuanto a los antibióticos seleccionados, la indicación quirúrgica y el tipo de intervención. Conclusiones: La implementación de la ligadura tardía de cordón y la extensión del acceso a leche de banco son áreas de mejora en el aspecto preventivo. En cuanto al diagnóstico y tratamiento existe una gran división que afecta precisamente a las áreas donde la evidencia en la literatura es menor. |
| first_indexed | 2024-12-16T23:02:18Z |
| format | Article |
| id | doaj.art-a249db642346428db6035ba98dc40f19 |
| institution | Directory Open Access Journal |
| issn | 2341-2879 |
| language | Spanish |
| last_indexed | 2024-12-16T23:02:18Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Anales de Pediatría (English Edition) |
| spelling | doaj.art-a249db642346428db6035ba98dc40f192022-12-21T22:12:42ZspaElsevierAnales de Pediatría (English Edition)2341-28792020-09-01933161169Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in SpainCarlos Zozaya0Alejandro Avila-Alvarez1Iván Somoza Argibay2Fermín García-Muñoz Rodrigo3Niki Oikonomopoulou4José Luis Encinas5Miguel Saenz de Pipaón6María Luz Couce7Division of Neonatology. The Hospital for Sick Children, Toronto, Ontario, Canada; Corresponding author.Unidad de Neonatología, Servicio de Pediatría, Complexo Hospitalario Universitario A Coruña, SpainServicio de Cirugía Pediátrica, Complexo Hospitalario Universitario A Coruña, SpainServicio de Neonatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, SpainDivision of Neonatology. The Hospital for Sick Children, Toronto, Ontario, CanadaDepartamento de Cirugía Pediátrica, Hospital Universitario La Paz, Madrid, SpainServicio de Neonatología, Hospital Universitario La Paz, Madrid, SpainServicio de Neonatología, Hospital Clínico Universitario de Santiago de Compostela. Universidad de Santiago, IDIS, CIBERER, Santiago de Compostela, A Coruña, SpainObjectives: To describe preventive, diagnostic and therapeutic strategies regarding necrotising enterocolitis in Spain and to identify the strengths, areas of further improvement, and future research lines. Methods: Two questionnaires on the management of preterm infants less than 32 weeks, at risk of, or with diagnosed necrotising enterocolitis, were distributed among selected representatives of the surgeons and neonatologists of the Spanish Neonatal Network (SEN1500) participant hospitals with a Paediatric Surgery Department. Results: Percentage of response was 77.1% of contacted surgeons and 88.6% of neonatologists. There is a written protocol on the diagnosis and medical management of necrotising enterocolitis in 52% of the hospitals, and as regards surgical treatment in 33%. There is wide access to donor bank milk and to staff dedicated to breastfeeding promotion (87%). On the contrary, only 52% of the centres perform delayed cord clamping, and probiotics are used in just 23%. The use of abdominal ultrasound is increasing. There are no large differences as regards duration of antibiotic use and bowel rest, whereas there was as regards antibiotic selection, surgical indication, and type of intervention. Conclusions: As regards prevention, delayed cord clamping and extended access to donor milk are two possible aspects of further improvement. The observed discrepancies noted in diagnostic and therapeutic aspects are common in precisely the areas where evidence in the literature is weakest. Resumen: Objetivo: Describir la prevención, diagnóstico y tratamiento de la enterocolitis necrosante en hospitales españoles e identificar puntos fuertes, áreas de mejora y líneas de investigación pendientes. Métodos: Se realizaron 2 encuestas sobre manejo de pacientes en riesgo o diagnóstico de enterocolitis necrosante en recién nacidos pretérmino menores de 32 semanas, distribuidas entre representantes de los cirujanos pediátricos y neonatólogos de los centros participantes en la red española SEN 1500 con Servicio de Cirugía Pediátrica. Resultados: El porcentaje de respuestas fue del 77.1% y del 88.6% entre los cirujanos y neonatólogos contactados, respectivamente. El 52% de los hospitales dispone de un protocolo de diagnóstico y manejo médico de la enterocolitis y el 33% uno sobre tratamiento quirúrgico. El acceso a leche de banco y disponer de personal dedicado a la promoción de la lactancia materna es común (87%), por el contrario, la ligadura tardía de cordón solo se realiza en el 52% de los centros y en un 23% se administran probióticos. La ecografía abdominal está cada vez más extendida. No hay grandes diferencias en cuanto a la duración de los antibióticos y del reposo intestinal, pero si en cuanto a los antibióticos seleccionados, la indicación quirúrgica y el tipo de intervención. Conclusiones: La implementación de la ligadura tardía de cordón y la extensión del acceso a leche de banco son áreas de mejora en el aspecto preventivo. En cuanto al diagnóstico y tratamiento existe una gran división que afecta precisamente a las áreas donde la evidencia en la literatura es menor.http://www.sciencedirect.com/science/article/pii/S2341287920301368Enterocolitis necrosantePrevenciónDiagnósticoTratamientoCirugía |
| spellingShingle | Carlos Zozaya Alejandro Avila-Alvarez Iván Somoza Argibay Fermín García-Muñoz Rodrigo Niki Oikonomopoulou José Luis Encinas Miguel Saenz de Pipaón María Luz Couce Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain Anales de Pediatría (English Edition) Enterocolitis necrosante Prevención Diagnóstico Tratamiento Cirugía |
| title | Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain |
| title_full | Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain |
| title_fullStr | Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain |
| title_full_unstemmed | Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain |
| title_short | Prevention, diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in Spain |
| title_sort | prevention diagnosis and treatment of necrosing enterocolitis in newborns less than 32 weeks at birth in spain |
| topic | Enterocolitis necrosante Prevención Diagnóstico Tratamiento Cirugía |
| url | http://www.sciencedirect.com/science/article/pii/S2341287920301368 |
| work_keys_str_mv | AT carloszozaya preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT alejandroavilaalvarez preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT ivansomozaargibay preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT fermingarciamunozrodrigo preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT nikioikonomopoulou preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT joseluisencinas preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT miguelsaenzdepipaon preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain AT marialuzcouce preventiondiagnosisandtreatmentofnecrosingenterocolitisinnewbornslessthan32weeksatbirthinspain |