Details

Autor(en) / Beteiligte

• Bubberman, J.M.
• van Zoonen, A.
• Bruggink, J.L.M.
• van der Heide, M.
• Berger, R.M.F.
• Bos, A.F.
• Kooi, E.M.W.
• Hulscher, J.B.F.

Titel

Necrotizing Enterocolitis Associated with Congenital Heart Disease: a Different Entity?

Ist Teil von

• Journal of pediatric surgery, 2019-09, Vol.54 (9), p.1755-1760

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Necrotizing enterocolitis (NEC) predominantly occurs in preterm infants (PT-NEC). In term neonates, NEC occurs more frequently when a congenital heart disease is present (CHDNEC). Our aim was to evaluate differences and similarities in disease characteristics of PT-NEC versus CHD-NEC. In this retrospective case–control study we identified all CHD infants who developed NEC Bell's stage ≥2 in our center from 2004 to 2014. We randomly selected (1:2 ratio) PT-NEC infants from the same period. Biochemical and clinical variables were retrieved from patient files. We found 18 CHD-NEC infants and selected 36 PT-NEC infants (gestational age 28.3 [25–35.6] weeks vs. 38.6 [31.7–40.7] weeks). Postnatal age at onset was significantly lower in CHD-NEC patients (4 [2–24] vs. 11 [4–41] days, p < 0.001). Lowest pH levels were lower (7.21 [7.01–7.47] vs. 7.27 [6.68–7.39], p = 0.02), and highest CRP levels were higher (112.5 mg/L [5.0–425.0] vs. 66.0 [5.2–189.0], p = 0.05) in PT-NEC vs. CHD-NEC. Anatomic localisation of the disease differed: the colon was significantly more often involved in CHD-NEC versus PT-NEC (86% vs. 33%, p = 0.03). Mortality caused by NEC was not different (22% vs. 11%, p = 0.47). While outcome of NEC in both groups is similar, the predominant NEC localisation differed between CHD-NEC and PT-NEC patients. This suggests that both variants of the disease have a different underlying pathophysiological mechanism that predisposes different intestinal regions to develop NEC. Retrospective Case–Control Study. Level III.