Transcript File - Respiratory Therapy Files

NEC
Necrotizing
enterocolitis
What does it
mean?
•
•
•
•
Necrotizing= the death of tissues
entero= small intestine
colo= the large intestine
itis= inflammation
• Necrotizing enterocolitis (NEC) is a disease that
affects mostly the intestine of premature infants. The
wall of the intestine is invaded by bacteria, which
cause local infection and inflammation that can
destroy the wall of the bowel (intestine).
History of NEC
• In The Beginning NEC was first described in 1950’s
and later became recognized clinically in the 1960’s
and 1970’s.
• It was first well-characterized in 1964. Prior to that
year, it almost did not exist. In 1964 in New York 21
cases of True NEC had been reported.
• It was not until respiratory support was adequate
to save premature children with immature lungs that
the disease became clinically important.
The exact cause of NEC condition
• are still idiopathic (unknown). However, it’s believed that a lack
of oxygen during a difficult delivery may be a contributing
factor. When there’s reduced oxygen or blood flow to the
intestine, it can become weak. This makes it easier for bacteria
from food to enter the intestine and cause damage to the
intestinal tissues. This can lead to development of an infection
or NEC.
• Premature babies often have underdeveloped body systems.
This may cause them to have difficulty with digestion, fighting
infection, and blood and oxygen circulation.
• This is one of the most common GI emergency in newborns.
Sign and Symptoms
Include:
•
•
•
•
•
•
swelling or bloating of the abdomen
discoloration of the abdomen
bloody stool
diarrhea
poor feeding
vomiting
symptoms of an infection include:
• apnea, or disrupted breathing
• fever
• lethargy
The condition can become life-threatening if it’s not treated.
How can it be
diagnosed?
A doctor can do a physical examination which include:
•
gently touch the baby’s abdomen to check for swelling,
pain, and tenderness.
•
They’ll then perform an abdominal X-ray. The X-ray can show signs of
inflammation.
•
The stool can also be tested to look for the presence of blood. This is called a
stool guaiac test.
•
Certain blood tests are needed to measure the platelet levels and white blood
cell counts. Low platelet levels or a high white blood cell count can be a sign of
NEC.
•
Inserting a needle into the baby’s abdominal cavity to check for fluid in the
intestine may be needed. The presence of intestinal fluid usually means
there’s a hole in the intestine.
Treatment
• Stop feeding and baby will receive their fluids
and nutrients intravenously or through an IV.
• Antibiotics to help fight infection.
• If difficulty breathing due to a swollen abdomen, they’ll receive extra
oxygen or breathing assistance.
• Sometimes depending on the severity, surgery may be needed and the
procedure may be removal of the damaged sections of the intestines.
The mortality rate is 20 to 35%. Aggressive support and surgical intervention
may maximize the chance of survival. Most babies recover without
complications once they are treated.
Prevention of NEC still remains unknown,
but things that can minimize NEC include:
• Avoidance of preterm births
• use of antenatal steroids
• breast-milk feeding
These are practices that offer the greatest potential
benefits until further research.