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REVIEW ARTICLE
Korean J Pediatr 2011 September;54(9) :368-372.
doi:https://doi.org/10.3345/kjp.2011.54.9.368
An update on necrotizing enterocolitis: pathogenesis and preventive strategies
Jang Hoon Lee (Lee JH)
Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
Corresponding Author: Jang Hoon Lee ,Tel: +82-31-219-5165, Fax: +82-31-219-5169, Email: neopedlee@gmail.com
Copyright © 2011 by The Korean Pediatric Society
ABSTRACT
Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.
Keywords: Necrotizing enterocolitis | Infant | Premature | Pathogenesis | Prevention
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Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies   2014 December;57(12)
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