Format

Send to

Choose Destination
J Perinatol. 2019 Nov;39(11):1521-1527. doi: 10.1038/s41372-019-0448-0. Epub 2019 Aug 1.

Variable management strategies for NEC totalis: a national survey.

Author information

1
Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA. apyle@connecticutchildrens.org.
2
Department of Pediatrics, Yale-New Haven Children's Hospital, New Haven, CT, USA.
3
Department of Surgery, University of Massachusetts, Boston, MA, USA.
4
Department of Surgery, Yale-New Haven Children's Hospital, New Haven, CT, USA.
5
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
6
Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.

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.

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.

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.

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.

PMID:
31371831
DOI:
10.1038/s41372-019-0448-0

Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center