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KMID : 1130320100530020167
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Korean Journal of Pediatrics
2010 Volume.53 No. 2 p.167 ~ p.172
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Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants
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Kim Jin-Kyu
Kim Yi-Sun
Yoo Hye-Soo
Ahn So-Yoon
Suh Hyun-Joo
Choi Seo-Hui
Park Soo-Kyung
Jung Yu-Jin
Kim Myo-Jing
Jeon Ga-Won
Koo Soo-Hyun
Lee Kyung-Hoon
Chang Yun-Sil
Park Won-Soon
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Abstract
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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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KEYWORD
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Extremely low birth weight, Necrotizing enterocolitis, Laparotomy, Prognosis
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