Korean J Pediatr.
2010 Feb;53(2):167-172. 10.3345/kjp.2010.53.2.167.
Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants
- Affiliations
-
- 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
- 2Department of Pediatrics, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
- 3Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Department of Pediatrics, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.
- 5Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea.
- KMID: 2281361
- DOI: http://doi.org/10.3345/kjp.2010.53.2.167
Abstract
- PURPOSE
With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC.
METHODS
We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center.
RESULTS
Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P=0.022) and fraction of inspired oxygen (P<0.001) were significantly higher in the dead group and values of base excess (P=0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, CO2, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P=0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P=0.022).
CONCLUSION
Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.
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