Necrotizing Enterocolitis in the Neonatal Intensive Care Unit (NICU): Case Control Review
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Authors
Ferrie, LaRae
Rubarth, Lori
Heise, Theresa
Schram, Laura
Soyer, Leslie
Issue Date
2013-06-05
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Abstract
Purpose: Necrotizing enterocolitis is the leading cause of morbidity and mortality among premature infants in the neonatal intensive care unit, with higher mortality rates seen in the earlier gestation and lower birth weight infants.|Methods: A retrospective chart review using a case control study was conducted on infants less than 32 weeks gestation and 1500 grams, diagnosed with Stage II or greater necrotizing enterocolitis (NEC), and admitted to the selected NICU from January 1, 2006 to November 1, 2012. The variables compared included, day of life of initiation of feeds, day of life at full feeds, product fed, antibiotics within the first week of life for greater than five days, and presence of a patent ductus arteriosus (PDA) and umbilical lines.|Results: The final study sample contained 38 control and 38 case infants. Results of the study showed the only statistically significant relationship was the day of life when feedings were initiated (p-value of 0.045) and the day of life when the infants reached full volume and calorie feeds (p-value of 0.004). In addition, there was no significant relationship between the types of product fed, antibiotic treatment, and presence of PDA. Data regarding the presence of umbilical lines was not statistically analyzed as all infants in the case and control group had umbilical lines.|Conclusion: The results of this study conclude the need for a standardized feeding protocol, including when feeds are initiated and how quickly they are advanced in the premature infant less than 32 weeks gestation and 1500 grams. Although many variables are thought to be associated with the incidence of NEC, this research supports standardizing a feeding protocol, which may help decrease the incidence of this life threatening condition.
PURPOSE: Necrotizing enterocolitis is the leading cause of morbidity and mortality among premature infants in the neonatal intensive care unit, with higher mortality rates seen in the earlier gestation and lower birth weight infants. METHODS: A retrospective chart review using a case control study was conducted on infants less than 32 weeks gestation and 1500 grams, diagnosed with Stage II or greater necrotizing enterocolitis (NEC), and admitted to the selected NICU from January 1, 2006 to November 1, 2012. The variables compared included, day of life of initiation of feeds, day of life at full feeds, product fed, antibiotics within the first week of life for greater than five days, and presence of a patent ductus arteriosus (PDA) and umbilical lines. RESULTS: The final study sample contained 38 control and 38 case infants. Results of the study showed the only statistically significant relationship was the day of life when feedings were initiated (p-value of 0.045) and the day of life when the infants reached full volume and calorie feeds (p-value of 0.004). In addition, there was no significant relationship between the types of product fed, antibiotic treatment, and presence of PDA. Data regarding the presence of umbilical lines was not statistically analyzed as all infants in the case and control group had umbilical lines. CONCLUSIONS: The results of this study conclude the need for a standardized feeding protocol, including when feeds are initiated and how quickly they are advanced in the premature infant less than 32 weeks gestation and 1500 grams. Although many variables are thought to be associated with the incidence of NEC, this research supports standardizing a feeding protocol, which may help decrease the incidence of this life threatening condition.
PURPOSE: Necrotizing enterocolitis is the leading cause of morbidity and mortality among premature infants in the neonatal intensive care unit, with higher mortality rates seen in the earlier gestation and lower birth weight infants. METHODS: A retrospective chart review using a case control study was conducted on infants less than 32 weeks gestation and 1500 grams, diagnosed with Stage II or greater necrotizing enterocolitis (NEC), and admitted to the selected NICU from January 1, 2006 to November 1, 2012. The variables compared included, day of life of initiation of feeds, day of life at full feeds, product fed, antibiotics within the first week of life for greater than five days, and presence of a patent ductus arteriosus (PDA) and umbilical lines. RESULTS: The final study sample contained 38 control and 38 case infants. Results of the study showed the only statistically significant relationship was the day of life when feedings were initiated (p-value of 0.045) and the day of life when the infants reached full volume and calorie feeds (p-value of 0.004). In addition, there was no significant relationship between the types of product fed, antibiotic treatment, and presence of PDA. Data regarding the presence of umbilical lines was not statistically analyzed as all infants in the case and control group had umbilical lines. CONCLUSIONS: The results of this study conclude the need for a standardized feeding protocol, including when feeds are initiated and how quickly they are advanced in the premature infant less than 32 weeks gestation and 1500 grams. Although many variables are thought to be associated with the incidence of NEC, this research supports standardizing a feeding protocol, which may help decrease the incidence of this life threatening condition.
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Creighton University
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