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Predicting intestinal recovery after necrotizing enterocolitis in preterm infants

Kuik, S. J., Kalteren, W. S., Mebius, M. J., Bos, A. F., Hulscher, J. B. F. & Kooi, E. M. W., Apr-2020, In : Pediatric Research. 87, 5, p. 903-909 7 p.

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  • Predicting intestinal recovery after necrotizing enterocolitis in preterm infants

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DOI

BACKGROUND: Intestinal recovery after NEC is difficult to predict in individuals. We evaluated whether several biomarkers predict intestinal recovery after NEC in preterm infants.

METHODS: We measured intestinal tissue oxygen saturation (rintSO2) and collected urinary intestinal-fatty binding protein (I-FABPu) levels 0-24 h and 24-48 h after NEC onset, and before and after the first re-feed. We assessed intestinal recovery in two ways: time to full enteral feeding (FEFt; below or equal/above group's median) and development of post-NEC complications (recurrent NEC/post-NEC stricture). We determined whether the rintSO2, its range, and I-FABPu differed between groups.

RESULTS: We included 27 preterm infants who survived NEC (Bell's stage ≥ 2). Median FEFt was 14 [IQR: 12-23] days. Biomarkers only predicted intestinal recovery after the first re-feed. Mean rintSO2 ≥ 53% combined with mean rintSO2range ≥ 50% predicted FEFt < 14 days with OR 16.7 (CI: 2.3-122.2). The rintSO2range was smaller (33% vs. 51%, p < 0.01) and I-FABPu was higher (92.4 vs. 25.5 ng/mL, p = 0.03) in case of post-NEC stricture, but not different in case of recurrent NEC, compared with infants without complications.

CONCLUSION: The rintSO2, its range, and I-FABPu after the first re-feed after NEC predicted intestinal recovery. These biomarkers have potential value in individualizing feeding regimens after NEC.

Original languageEnglish
Pages (from-to)903-909
Number of pages7
JournalPediatric Research
Volume87
Issue number5
Early online date24-Oct-2019
Publication statusPublished - Apr-2020

    Keywords

  • NEAR-INFRARED SPECTROSCOPY, SUPERIOR MESENTERIC-ARTERY, ACID-BINDING PROTEIN, SPLANCHNIC OXYGENATION, INTERNATIONAL SURVEY, TISSUE OXYGENATION, ISCHEMIA, RISK, MANAGEMENT, DIAGNOSIS

ID: 101549560