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Variable management strategies for NEC totalis: a national survey.
- Source :
-
Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2019 Nov; Vol. 39 (11), pp. 1521-1527. Date of Electronic Publication: 2019 Aug 01. - Publication Year :
- 2019
-
Abstract
- Background/objectives: Necrotizing enterocolitis (NEC) is a serious disease linked to prematurity. A variant, NEC totalis, is associated with nearly 100% mortality. There is wide variation in counseling practices for NEC totalis. Our objectives are to determine what treatment options, if any, are offered to families, and which factors influence these decisions.<br />Methods: An anonymous survey was distributed to members of the AAP Sections on Neonatal-Perinatal Medicine and Pediatric Surgery. Data were analyzed utilizing chi-square tests and Spearman correlations, where applicable.<br />Results: In the setting of NEC totalis, 90% of the 378 respondents viewed offering life-sustaining interventions (LSI) as ethically permissible and 87% felt that transfer to another center willing to provide LSI should be considered; however, only 43% reported offering LSI to families.<br />Conclusions: Management of NEC totalis remains challenging and significant practice variability persists. Most respondents do not offer ongoing medical/surgical management, despite believing it is an ethically permissible option.
- Subjects :
- Chi-Square Distribution
Combined Modality Therapy
Cross-Sectional Studies
Health Care Surveys
Humans
Infant, Newborn
Infant, Premature
Laparotomy statistics & numerical data
Neonatologists
Practice Patterns, Physicians' statistics & numerical data
Risk Factors
Surgeons
Ultrasonography
United States
Enterocolitis, Necrotizing diagnosis
Enterocolitis, Necrotizing therapy
Infant, Premature, Diseases diagnosis
Infant, Premature, Diseases therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5543
- Volume :
- 39
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of perinatology : official journal of the California Perinatal Association
- Publication Type :
- Academic Journal
- Accession number :
- 31371831
- Full Text :
- https://doi.org/10.1038/s41372-019-0448-0