Elliot C Pennington1, Patrick J Javid2, Veronica Sullins3, Claudia Mueller4, Catherine J Hunter5. 1. Helen DeVos Children's Hospital and Michigan State University College of Human Medicine, 330 Barclay Ave NE, Suite 202, Grand Rapids, MI 49503. 2. Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA. 3. Division of Pediatric Surgery, UCLA Mattel Children's Hospital, 10833 Le Conte Ave, Box 709818, Los Angeles, CA 90095, United States. 4. Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA 94305. 5. Oklahoma Children's Hospital. Electronic address: catherine-hunter@ouhsc.edu.
Abstract
PURPOSE: Necrotizing enterocolitis (NEC) totalis is a devastating disease of the newborn intestine. A precise clinical definition of the extent of gastrointestinal involvement is lacking in the existing literature, and the clinical outcomes are typically viewed as grim. METHODS: Herein, we present a series of clinical case examples of patients with varying degrees of NEC totalis and other co-morbid conditions, with possible anticipated outcomes based on current data. RESULTS: We define the key ethical issues and provide a framework and discussion of the ethical issues involved in the care of patients with NEC totalis and recommendations of how to approach discussions with the family of these patients We discuss the ethical considerations for both the providers caring for these patients, and the patient's family members. CONCLUSION: The management of patients with NEC totalis is complex and ethically challenging. LEVEL OF EVIDENCE: V.
PURPOSE: Necrotizing enterocolitis (NEC) totalis is a devastating disease of the newborn intestine. A precise clinical definition of the extent of gastrointestinal involvement is lacking in the existing literature, and the clinical outcomes are typically viewed as grim. METHODS: Herein, we present a series of clinical case examples of patients with varying degrees of NEC totalis and other co-morbid conditions, with possible anticipated outcomes based on current data. RESULTS: We define the key ethical issues and provide a framework and discussion of the ethical issues involved in the care of patients with NEC totalis and recommendations of how to approach discussions with the family of these patients We discuss the ethical considerations for both the providers caring for these patients, and the patient's family members. CONCLUSION: The management of patients with NEC totalis is complex and ethically challenging. LEVEL OF EVIDENCE: V.