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Preliminary resuscitation for perforated necrotizing enterocolitis: 2 cases treated with initial direct peritoneal

James W Hopkins1, Basaviah Chandramouli, Piper Wall

  • 1Department of Surgical Education, Research-Iowa Methodist Medical Center and Blank Children's Hospital, Iowa Health System, DesMoines, IA 50309-1453, USA. hopkinjw@ihs.org

Journal of Pediatric Surgery
|January 18, 2011
PubMed

Insights

Direct peritoneal resuscitation using dextrose solution aided in the recovery of two very low-birth-weight infants with necrotizing enterocolitis. This novel approach warrants further investigation in high-risk surgical patients.

Area of Science:

  • Neonatal surgery
  • Pediatric critical care
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in premature infants.
  • Perforated NEC requires surgical intervention and intensive resuscitation.
  • Limited resuscitation options exist for extremely low-birth-weight infants with NEC.

Observation:

  • Peritoneal infusions of 2.5% dextrose solution were administered every 12 hours for 7 days.
  • The treatment was given preoperatively and postoperatively following extensive bowel resection.
  • The technique was termed direct peritoneal resuscitation.

Findings:

  • Two very low-birth-weight infants with perforated NEC showed positive responses to direct peritoneal resuscitation.
  • The intervention was used as an adjunct to standard resuscitation protocols.
  • Early benefits suggest potential efficacy in high-risk NEC cases.

Implications:

  • Direct peritoneal resuscitation may offer a novel therapeutic option for critically ill neonates with NEC.
  • Further research, including prospective controlled trials, is needed to validate this technique.
  • This approach could potentially improve outcomes for high-risk infants with diffuse disease and shock.

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