All issues > Volume 53(2); 2010

Original Article

Korean J Pediatr. 2010;53(2):167-172. Published online February 15, 2010.

Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants

Jin Kyu JK Kim¹, Yi Sun YS Kim¹, Hye Soo HS Yoo¹, So Yoon SY Ahn¹, Hyun ju Hj Seo¹, Seo Heui SH Choi¹, Soo Kyung SK Park¹, Yu Jin YJ Jung¹, Myo Jing MJ Kim², Ga Won GW Jeon³, Soo Hyun SH Koo⁴, Kyung-Hoon KH Lee⁵, Yun Sil YS Chang¹, Won Soon WS Park¹

¹Department of Pediatrics, Samsung Medical Center, Seoul, Korea
²Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
³Department of Pediatrics, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
⁴Department of Pediatrics, Masan Samsung Hospital, Korea
⁵Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence Won Soon WS Park ,Tel: +82.2-3410-3523, Fax: +82.2-3410-0043, Email: wonspark@skku.edu

Abstract

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.

Keywords :Extremely low birth weight, Necrotizing enterocolitis, Laparotomy, Prognosis