+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Necrotizing Enterocolitis and Central Line Associated Blood Stream Infection Are Predictors of Growth Outcomes in Infants with Short Bowel Syndrome



Necrotizing Enterocolitis and Central Line Associated Blood Stream Infection Are Predictors of Growth Outcomes in Infants with Short Bowel Syndrome



Journal of Pediatrics 167(1): 35-40.E1



To describe the natural history of growth patterns and nutritional support in a cohort of infants with short bowel syndrome (SBS), and to characterize risk factors for suboptimal growth. A retrospective chart review of 51 infants with SBS followed by our intestinal rehabilitation program. Weight and length data were converted to age, sex, and gestational age-standardized weight-for-age z-scores (WAZ) and length-for-age z-scores (LAZ). Median (IQR) age at enrollment was 8.3 (0.9-14.6) weeks, and follow-up duration was 10 (8-13) months, including both inpatient and outpatient visits. Both WAZ and LAZ followed a U-shaped curve, with median for newborns (WAZ = -0.28; LAZ = -0.41), a nadir at age 6 months (-2.38 and -2.18), and near recovery by age 1 year (-0.72 and -0.76). Using multivariable regression analysis, diagnosis of necrotizing enterocolitis was independently associated with significant decrements of WAZ (-0.76 ± 0.32; P = .02) and LAZ (-1.24 ± 0.32; P = .0001). ≥ 2 central line-associated bloodstream infections was also independently associated with decreases in WAZ (-0.95 ± 0.33; P = .004) and LAZ (-0.86 ± 0.32; P = .007). In a cohort of infants with SBS, we observed a unique pattern of somatic growth, with concomitant deceleration of both WAZ and LAZ and near recovery by 1 year. Inflammatory conditions (necrotizing enterocolitis and central line-associated bloodstream infections) represent potentially modifiable risk factors for suboptimal somatic growth.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058383607

Download citation: RISBibTeXText

PMID: 25841540

DOI: 10.1016/j.jpeds.2015.02.053


Related references

Disruptions of the intestinal microbiome in necrotizing enterocolitis, short bowel syndrome, and Hirschsprung's associated enterocolitis. Frontiers in Microbiology 6: 1154, 2015

Bowel Perforation in Premature Infants with Necrotizing Enterocolitis: Risk Factors and Outcomes. Gastroenterology Research and Practice 2016: 6134187, 2016

Surgical treatment of necrotizing enterocolitis and the short bowel syndrome. Clinics in Perinatology 21(2): 365-387, 1994

Short- and long-term outcomes of necrotizing enterocolitis in infants with congenital heart disease. Pediatrics 123(5): E901-E906, 2009

Operative strategies for necrotizing enterocolitis: The prevention and treatment of short-bowel syndrome. Seminars in Pediatric Surgery 14(3): 191-198, 2005

Short-term surgical outcomes of preterm infants with necrotizing enterocolitis: A single-center experience. Medicine 95(30): E4379, 2016

Necrotizing enterocolitis is associated with earlier achievement of enteral autonomy in children with short bowel syndrome. Journal of Pediatric Surgery 51(1): 92-95, 2016

Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 115(3): 696-703, 2005

Neurodevelopmental and Growth Outcomes of Extremely Low Birth Weight Infants After Necrotizing Enterocolitis. Yearbook of Neonatal and Perinatal Medicine 2006: 298-300, 2006

Red blood cell transfusion in premature infants leads to worse necrotizing enterocolitis outcomes. Journal of Surgical Research 213: 158-165, 2017

Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants. Pediatric Infectious Disease Journal 35(4): 401-406, 2016

Does the initial surgery for necrotizing enterocolitis matter? Comparative outcomes for laparotomy vs. peritoneal drain as initial surgery for necrotizing enterocolitis in infants <1000 g birth weight. Journal of Pediatric Surgery 54(4): 712-717, 2019

G540(P)An improvement project to reduce central line associated blood stream infection (clabsi) in newborn infants. Archives of Disease in Childhood 100(Suppl 3): A238.2-A239, 2015

Multiple intestinal anastomoses to avoid short bowel syndrome and stimulate bowel maturity in type IV multiple intestinal atresia and necrotizing enterocolitis. Journal of Pediatric Surgery 47(3): 628, 2012

Differences in midterm outcomes in infants with hypoplastic left heart syndrome diagnosed with necrotizing enterocolitis: NPCQIC database analysis. Congenital Heart Disease 13(4): 512-518, 2018