The effect of supplemental parenteral nutrition on outcomes of necrotizing enterocolitis in premature, low birth weight neonates

Am J Surg. 2015 Dec;210(6):1045-9; discussion 1049-50. doi: 10.1016/j.amjsurg.2015.08.004. Epub 2015 Sep 14.

Abstract

Background: We hypothesized that supplemental parenteral nutrition (PN) decreases the need for surgery and mortality associated with necrotizing enterocolitis (NEC).

Methods: Single institution retrospective review of all premature, low birth weight infants with NEC from January 2006 to December 2013 was conducted.

Results: NEC was identified in 114 premature, low birth weight infants, 59 (51.8%) of which required surgical management. Surgical NEC infants were born younger (25.8 ± 4.0 vs 27.8 ± 3.3 weeks, P = .005) and weighed less at birth (829 ± 281 vs 938 ± 271 g, P = .038) than those managed medically. There was no difference in the use of PN (37.7% vs 31.4%, P = .541) between surgical and medical NEC patients. There was no statistically significant difference in mortality at discharge between patients who had PN at NEC onset and those who did not (31.4% vs 42.6%, P = .294) CONCLUSION: In this single-center study, supplemental PN at NEC onset does not appear to significantly improve outcomes as demonstrated by rates of surgical intervention and in-hospital mortality.

Keywords: Low birth weight; Mortality; Necrotizing enterocolitis; Parenteral nutrition; Premature infant; Surgical NEC.

MeSH terms

  • Enterocolitis, Necrotizing / mortality
  • Enterocolitis, Necrotizing / therapy*
  • Female
  • Hospital Mortality
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Parenteral Nutrition*
  • Retrospective Studies
  • Treatment Outcome