NECROTIZING ENTEROCOLITIS

PRESENTED BY, MS. L.SOUNDARYA

M.SC.NURSING (PEDIATRICS)

• NEC characterized by necrosis of the intestinal wall, is a serious life threatening condition that is being diagnosed with increasing frequency in premature infants

ETIOLOGY

• Perinatal asphyxia• Low apgar score• IRDS• Congenital heart disease • sepsis

• Ischemia/hypovolemia of the intestinal tract that is associated with; HypotensionUse of umbilical catheters Exchange transfusionhypertonic foodsMedications or fliuds

PATHOPHYSIOLOGY

Hypoxia, acidosis, hypoglycemia, low cardiac output, hypothermia

Decreased splanchnic blood flow

Hypertonic feeding –mucosal edema, ulceration

Intestinal colonization with E.Coli, KlebshellaInvasive infection by bowel flora

Bacterial invasion of portal system and lymphatic bowels

Transdural bowel necrosis

PerforationCollapse

Sepsis

Endotoxin releasePneumotosis intestinalis

Portal gas, septicemia

CLINICAL PRESENTATION

DIAGNOSTIC EVALUATION

• History collection• Physical examination• Blood test- bilirubin, serum electrolytes ,

blood sugar level, blood culture• Stool culture/ sensitivity • Abdominal x-ray/ USG• Hepatic ultrasonography

NURSING MANAGEMENT

Oral feeding should be discontinued peripheral IV fluids can be startedNG tube –to remove stomach contentsAntibiotic therapyPsychosocial support Hydrocorticosone may be givenRegular check up of vital signs Prevent cross infection.

Outcomes

• Re-occurance of the disease

• PREVENTION Fresh breast milk feeding to all

neonates