Necrotizing Enterocolitis (NEC)
By Jonas Wilson, Ing. Med.
Necrotizing enterocolitis (NEC) is a life-threatening condition that manifests as inflammation of the intestines. This devastating disease affects mostly premature babies, who account for up to 8 out of every 10 cases. In NEC, bacteria invade the intestinal wall and the local infection and inflammation lead to destruction of the intestinal lining and/ or its entire thickness. A breach in the integrity of the bowel wall enables bacteria to escape into the abdominal cavity. By this means, the bacteria cause a massive infection, which has the ability to progress quickly and may lead to death if not treated immediately. Hence, NEC is a medical emergency.
Patients typically present with swelling or bloating and poor feeding tolerance. Moreover, they may experience vomiting, blood in the stool, lethargy, apnea and fever. These signs and symptoms usually develop within the first 2 weeks of life. Diagnosis is made with the help of physical examination and abdominal X-rays, which may show the presence of air in the abdominal cavity. Treatment may vary depending on disease extent and the overall health of the infant, but includes antibiotic therapy, IV-feeding and in serious cases breathing support and surgery.
Epidemiology
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This frequency is suggested to be similar in other countries, but may be lower in countries with lower rates of premature births. NEC is more commonly seen in premature babies. The prevalence of NEC is equal between male and female babies and the incidence is inversely proportional to the gestational age and birth weight. The highest rates of NEC are seen in infants born with a weight at birth less than 1 kg. Infants born with a weight between 1.5 – 2.5 kg and those who are born after 36 weeks of gestation have significantly lower chances of developing
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
This paper will then explain the types of physical symptoms associated with NAS in the full-term and premature infant. It discusses the different classes of drugs and the unique symptoms newborns experience with each. Furthermore, it discusses the long-term cognitive and behavioral effects that newborns can experience as they grow. In addition, this paper discusses how Neonatal Abstinence Syndrome is diagnosed and the how the Finnegan neonatal scoring system is used to help physicians determine the severity of NAS in each newborn. Lastly, this paper explains the treatment for NAS and the important role of the nurse when caring for a newborn with Neonatal Abstinence Syndrome.
How is it diagnosed? • Usually before birth, around the second trimester, doctors can diagnose Sirenomelia through ultrasound or sonogram • Immediately after being born, doctors can tell if the baby has Sirenomelia through physical observation What are the possible complications? The severity of Sirenomelia varies among individuals. Many babies die during birth and those living can face long-term effects including: • Renal problems such as kidney failure or absence of either one or both kidneys • Cardiovascular problems such as Heart problems • Pulmonary problems include immature, small or abnormal lungs structures • Absent of bladder, large and small intestines and other organs • Abnormalities in upper extremity such as the brain, arms or spine • Inability to walk or move normally without the help of others • Present of urethral agenesis • Possible growth delay in the brain, arms or spine • Symptom How is it Treated?
NAS has turned into an epidemic espicially in the state of Tennessee a little more than 320 babies were born with NAS in 2013. Tennessee was the first state to start keeping track of the number of cases of NAS. NAS occurs when pregnant women take drugs such as heroin, codeine, oxycodone, methadone, or buprenorphine (“Babies are being born addicted to drugs”). This happens when the substances pass through the placenta that connects the baby to its mother. Then the baby becomes dependent on the drug like the mother. Hospitals began treating these cases with morphine, by administering a dosage of morphine every few hours as needed and reducing the dosage until the baby was better. During this process doctors need to keep a look out for the babies since the morphine can cause them to stop breathing. A baby born with NAS usually suffers from low birth weight and respiratory problems. Heroin and cocaine are some of the most common drugs being abused, and they both have short and long term effects other than withdrawal symptoms: Such as ph...
Necrotizing fasciitis, known commonly known as "flesh eating bacteria [infection]", occurs in a wide range of people 1. It occurs in the elderly, middle aged and younger patients. It occurs in athletes and debilitated individuals. It can occur in drug abusers with self inflicted wounds and healthy individuals with incidental injuries. It may occur in those with metabolic disorders such as diabetes and those with suppressed immune systems. It may occur in those with no underlying disorders and no known particular injury. It occurs under ordinary circumstances such as a seemingly harmless cut or scrape and in wounds resulting from major trauma such as an auto accident.
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
Reddy, U. M., Zhang, J., Sun, L., Chen, Z., Raju, T. N., & Laughon, K. (2012). Neonatal mortality by attempted route of delivery in early preterm birth. American Journal of Obstetrics & Gynecology, 207(2). doi:10.1016/j.ajog.2012.06.023
E. coli are bacteria that can cause an infection in various parts of your body, including your intestines. E. coli bacteria normally live in the intestines of people and animals. Most types of E. coli do not cause infections, but some produce a poison (toxin) that can cause diarrhea. Depending on the toxin, this can cause mild or severe diarrhea.
Low birth weight can be defined as baby born with weight less than 2500g. It is one of the adverse pregnancy results in the world, which is affected to the newborn survival, growth and development. There are categorizes in the low birth weight; very low birth weight which a birth weight is less than 1500g and extremely low birth weight which is a birth weight is less than 1000g. An estimated 18 million babies are born worldwide each year with low birth weight and 9.3 million of them in south Asia. Low birth weight percentage in Sri lanka is 16% and is high in the developing countries. At that time, the low birth weight (LBW) rate for industrialized countries are 5%-7%. In England and Wales, the incidence of low birth weight increased from 6.5 percent in 1980 to 6.7 percent in 1990, while that of very low birth weight increased from 0.78 in 1980 to 0.98 percent in 1990 (and 1.2 percent in 1996 - Masuy-Stroobant and Gourbin, 1995, p. 73; Petrou, 2003, referring to
inflammatory bowel disease. Typically, it causes inflammation in the digestive tract which can result in ulcers.
Each year there are over five hundred thousand babies that are born premature. Neonatology is the pediatric subspecialty trained specifically to handle these complex and high-risk situations that newborn babies face. Neonatologists dedicate their practice to babies born in hospitals, but not yet released, or to those transferred into Neonatal Intensive Care Units, also known as NICUs. Over the past one hundred years, the rate of survival for premature babies has increased from five percent to ninety-five percent. Neonatology is a very risky, but important job that is critical to the well-being of newborn babies.
Birth weight of a child is the first and most important indicator of his/her health condition. Birth weight is the first weight of fetus obtained after birth. But this is a final result of long process which is accomplished by maternal nutrition. Unless child is a preterm baby (born before the end of 3rd trimester) he/she should be averagely more than 2,500g of weight to consider as normal (WHO, 2000).This is not only a risk for under developed or developing countries but affecting to developed countries as well. There are numerous factors affecting this adverse situation. In this document it is going to be discussed thoroughly and widely with some logical solutions which should be ideal to introduce immediately. As concerned above this low birth weight (LBW) issue has caused to many health impairments in latter part of the life. This impaired fetal feeding and the resulting intrauterine growth restriction has being caused for infant mortality by 8-17 % of pregnancies in the developed and developing countries (UNICEF, 2003). Though the child was low in weight he/she may bear many health problems inside the body which are shown at the elderly period. To describe the prevalence of this low birth weight all over the world, the table 01 is given below.
There were 29 newborns (16 girls; 13 boys), 30 three month olds (16 girls; 14 boys), 30 six month olds (13 girls; 17 boys), 30 nine month olds (13 girls; 17 boys), and 26 twelve month olds (11 girls; 15 boys). Furthermore, 85 infants were eliminated due to interferences and technical problems, and an additional 18 infants were excluded in order to equalize sample sizes.
The patient has experienced fever, chills on body, headaches and anorexia as well as sweating especially during the night. The patient has also been feeling fatigued, muscle aches and nausea as well as vomiting especially after eating (WHO, 2010, p. 117). These symptoms started forty eight hours ago, and the patient has not taken any medication except for some aspirin.