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1

F, Gilchrist Brian, ed. Necrotizing enterocolitis. Georgetown, Tex: Eurekah.com, 2000.

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2

Stirt, Joseph A. Baby. Far Hills, N.J: New Horizon Press, 1992.

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3

Hackam, David J. Necrotizing Enterocolitis: Pathogenesis, Diagnosis and Treatment. Taylor & Francis Group, 2020.

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Hackam, David J. Necrotizing Enterocolitis: Pathogenesis, Diagnosis and Treatment. Taylor & Francis Group, 2020.

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Hackam, David J. Necrotizing Enterocolitis: Pathogenesis, Diagnosis and Treatment. Taylor & Francis Group, 2021.

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6

Hackam, David J. Necrotizing Enterocolitis: Pathogenesis, Diagnosis and Treatment. Taylor & Francis Group, 2020.

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7

Hackam, David J. Necrotizing Enterocolitis: Pathogenesis, Diagnosis and Treatment. Taylor & Francis Group, 2020.

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8

Hylton, Jared, and Sarah Deverman. Necrotizing Enterocolitis. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0001.

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Necrotizing enterocolitis (NEC) is a potentially life-threatening condition that affects mainly preterm infants. It is one of the most common surgical emergencies in the neonatal intensive care unit. While medical management is the first line of treatment, if that fails, NEC becomes a surgical emergency, and the pediatric anesthesiologist must be prepared. This chapter covers the pathogenesis, risk factors, clinical presentation and diagnosis, prevention, medical and surgical management, pre- and intraoperative anesthetic assessment, and postoperative management of NEC. Topics covered include intestinal perforation, necrotizing enterocolitis, neonatal anesthesia, pneumatosis intestinalis, prematurity, and ventilatory management. The chapter ends with review questions on the chapter’s content.
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9

Hackam, David J. Necrotizing Enterocolitis: Insights into Pathogenesis, Diagnosis and Treatment. World Scientific Publishing Co Pte Ltd, 2017.

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10

Viscardi, Rose M., and Ken B. Waites. Ureaplasma urealyticum and Ureaplasma parvum. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190604813.003.0022.

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The Mycoplasma species Ureaplasma parvum and Ureaplasma urealyticum colonize the human adult urogenital tract and are not typically associated with disease. Perinatal transmission, however, has been implicated in the pathogenesis of preterm birth, chorioamnionitis, and other complications of extreme prematurity, including neonatal pneumonitis, bronchopulmonary dysplasia (BPD), meningitis, and necrotizing enterocolitis (NEC). This chapter reviews the biology of these organisms. Epidemiologic and experimental evidence supporting a role for ureaplasmas in the pathogenesis of neonatal disease, clinical manifestations of infection in the infant, current microbiologic diagnostic methods, and the present status of treatment options are reviewed. Macrolide antibiotic therapy is controversial for infected infants, and current concepts regarding candidates for treatment are discussed. Key unanswered questions that need to be addressed in future research studies are also suggested.
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11

Puntis, John. Necrotizing enterocolitis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198759928.003.0007.

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Necrotizing enterocolitis is a common and serous disease predominantly affecting premature newborns, with an incidence, morbidity, and mortality that has remained unchanged for several decades. Around 7% of infants between 500g and 1500g birth weight are affected, with the disease often manifesting with vomiting, bilious aspirates, distended abdomen, and blood in stools around 8–10 days of age. Medical management includes decompression of the gastrointestinal tract via a nasogastric tube, broad-spectrum antibiotics, and bowel ‘rest’ (total parenteral nutrition). Surgical intervention is required for intestinal perforation or ongoing deterioration despite medical management. The pathogenesis is multifactorial and includes genetic predisposition, gastrointestinal immaturity, imbalance in microvascular tone, abnormal intestinal microbiological colonization, and a highly immunoreactive intestinal mucosa. Breast milk feeds appear to confer some degree of protection.
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12

Stirt, Joseph A. Baby. Lübbe, 2002.

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13

McAdam, Dugald. Exploratory Laparotomy for Necrotizing Enterocolitis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0051.

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The survival rates of very-low-birth weight (VLBW; birth weight <1,500 g) and extremely-low-birth weight (ELBW; birth weight <1,000 g) infants have increased with improvements in antenatal and postnatal care. These include the use of antenatal steroids, artificial surfactant, and ventilation strategies that have reduced injury to the neonatal lung. As a result, the pediatric anesthesiologist is now more often faced with the task of safely caring for these infants, often in unfamiliar environments, and sometimes during episodes of life-threatening illness. One example is necrotizing enterocolitis (NEC) requiring surgical management.
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14

Wyatt, Karla E. K., and Olutoyin A. Olutoye. Exploratory Laparotomy for Necrotizing Enterocolitis. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0046.

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Necrotizing enterocolitis (NEC) is a severe inflammatory bowel disease that commonly affects premature infants. The pathogenesis is multifactorial and poorly understood, although certain risk factors have been identified. This disease, more commonly detected in premature infants with accompanying cardiac and pulmonary comorbid conditions, is associated with increased morbidity and mortality. Multiorgan system homeostasis becomes critical for the pediatric anesthesiologist when approaching medical and surgical interventions for affected patients. This chapter focuses on the population at risk for developing necrotizing enterocolitis, medical and surgical management, providing anesthesia care in the neonatal intensive care unit, as well as perioperative considerations and complications.
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15

Chunbao, Guo, Yingjie Lu, and Yuan Shi, eds. Intestinal Microbiota in the Pathogenesis and Management of Necrotizing Enterocolitis in Preterm Infants. Frontiers Media SA, 2022. http://dx.doi.org/10.3389/978-2-88974-665-1.

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16

Beattie, R. Mark, Anil Dhawan, and John W.L. Puntis. The premature newborn. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569862.003.0004.

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General principles 38Parenteral nutrition 39Enteral feeding 40Developments in care for the premature newborn have lead to increasing survival (50% of infants born at 24 weeks gestation) and an increased awareness of the importance of nutrtional support. Many have difficulty tolerating enteral nutrition in the early weeks of life until gastrointestinal motility has matured. Some develop necrotizing enterocolitis (NEC) which carries a high risk of morbidity and mortality, and may be regarded as a failure of adaptation to postnatal life. Optimum nutrition should allow adequate growth in the short term, free of metabolic and other complications, with long-term fulfilment of both genetic growth and developmental potential....
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17

Puntis, John. The premature newborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198759928.003.0006.

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Infants born at 24 weeks’ gestation now have a 40% chance of survival, rising to 80% at 26 weeks. Many have difficulty tolerating enteral feeds because of gastrointestinal immaturity; during this time parenteral nutrition is commonly given. Undernutrition in the early weeks of life may have lasting effects on developmental outcomes and increase the risk of certain chronic diseases in adult life (e.g. hypertension, cardiovascular disease, diabetes). Breast milk appears to confer some protection against necrotizing enterocolitis and be good for brain development. There has been a resurgence of investment in milk banks so that donor milk from nursing mothers in the community can be processed and given to preterm infants whose mothers cannot provide sufficient milk of their own. When breast milk is unavailable, preterm formula should be used, and following discharge from hospital (when many infants are showing a growth deficit), a nutrient-enriched formula can be given.
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18

Sivak, Erica, Marcus Malek, and Denise Hall-Burton. Hirschsprung Disease. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0037.

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Hirschsprung disease is characterized by the absence of ganglion cells in the enteric nervous system. Inability to pass meconium in the neonatal period, enterocolitis, bowel obstruction, or chronic constipation in older infants and children may be the presenting symptoms. Once diagnosed, surgical intervention is always required. Successful resection of all portions of aganglionic intestine may be accomplished through multiple surgical techniques. Depending upon the surgical approach required, regional anesthesia may be indicated to assist with pain control postoperatively. This chapter describes Hirschsprung disease and considers a variety of questions related to its diagnosis and treatment, as well as risks related to surgery, including anaphylaxis, laparoscopic complications, vascular injury, epidural complications, and issues related to neuraxial analgesia.
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