Carlos Zozaya1, Alejandro Avila-Alvarez2, Iván Somoza Argibay3, Fermín García-Muñoz Rodrigo4, Niki Oikonomopoulou5, José Luis Encinas6, Miguel Saenz de Pipaón7, María Luz Couce8. 1. División de Neonatología, The Hospital for Sick Children, Toronto, Ontario, Canadá. Electronic address: carlos.zozaya@sickkids.ca. 2. Unidad de Neonatología, Servicio de Pediatría, Complexo Hospitalario Universitario A Coruña, A Coruña, España. 3. Servicio de Cirugía Pediátrica, Complexo Hospitalario Universitario A Coruña, A Coruña, España. 4. Servicio de Neonatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, España. 5. División de Neonatología, The Hospital for Sick Children, Toronto, Ontario, Canadá. 6. Departamento de Cirugía Pediátrica, Hospital Universitario La Paz, Madrid, España. 7. Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España. 8. Servicio de Neonatología, Hospital Clínico Universitario de Santiago de Compostela. Universidad de Santiago, IDIS; CIBERER, Santiago de Compostela, A Coruña, España.
Abstract
OBJECTIVES: To describe preventive, diagnostic and therapeutic strategies regarding necrotising enterocolitis in Spain and to identify the strengths, areas of further improvement, and future research lines. METHODS: Two questionnaires on the management of preterm infants less than 32 weeks, at risk of, or with diagnosed necrotising enterocolitis, were distributed among selected representatives of the surgeons and neonatologists of the Spanish Neonatal Network (SEN1500) participant hospitals with a Paediatric Surgery Department. RESULTS: Percentage of response was 77.1% of contacted surgeons and 88.6% of neonatologists. There is a written protocol on the diagnosis and medical management of necrotising enterocolitis in 52% of the hospitals, and as regards surgical treatment in 33%. There is wide access to donor bank milk and to staff dedicated to breastfeeding promotion (87%). On the contrary, only 52% of the centres perform delayed cord clamping, and probiotics are used in just 23%. The use of abdominal ultrasound is increasing. There are no large differences as regards duration of antibiotic use and bowel rest, whereas there was as regards antibiotic selection, surgical indication, and type of intervention. CONCLUSIONS: As regards prevention, delayed cord clamping and extended access to donor milk are two possible aspects of further improvement. The observed discrepancies noted in diagnostic and therapeutic aspects are common in precisely the areas where evidence in the literature is weakest.
OBJECTIVES: To describe preventive, diagnostic and therapeutic strategies regarding necrotising enterocolitis in Spain and to identify the strengths, areas of further improvement, and future research lines. METHODS: Two questionnaires on the management of preterm infants less than 32 weeks, at risk of, or with diagnosed necrotising enterocolitis, were distributed among selected representatives of the surgeons and neonatologists of the Spanish Neonatal Network (SEN1500) participant hospitals with a Paediatric Surgery Department. RESULTS: Percentage of response was 77.1% of contacted surgeons and 88.6% of neonatologists. There is a written protocol on the diagnosis and medical management of necrotising enterocolitis in 52% of the hospitals, and as regards surgical treatment in 33%. There is wide access to donor bank milk and to staff dedicated to breastfeeding promotion (87%). On the contrary, only 52% of the centres perform delayed cord clamping, and probiotics are used in just 23%. The use of abdominal ultrasound is increasing. There are no large differences as regards duration of antibiotic use and bowel rest, whereas there was as regards antibiotic selection, surgical indication, and type of intervention. CONCLUSIONS: As regards prevention, delayed cord clamping and extended access to donor milk are two possible aspects of further improvement. The observed discrepancies noted in diagnostic and therapeutic aspects are common in precisely the areas where evidence in the literature is weakest.
Authors: Carlos Zozaya; Inés García González; Alejandro Avila-Alvarez; Niki Oikonomopoulou; Tomás Sánchez Tamayo; Enrique Salguero; Miguel Saenz de Pipaón; Fermín García-Muñoz Rodrigo; María L Couce Journal: Front Pediatr Date: 2020-05-13 Impact factor: 3.418