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Necrotizing Enterocolitis





  • Premature infant considerations 

  • ↑ risk of aspiration:

    • Bowel obstruction, dilated bowel loops, pneumatosis intestinalis

  • Associated multisystem derangements:

    • Hypoxia

    • Sepsis, hypovolemia

    • DIC, thrombocytopenia

    • Metabolic acidosis

  • Associated conditions:

    • Birth asphyxia, hypotension, respiratory distress syndrome, patent ductus arteriosus, recurrent apnea, intestinal ischemia, systemic infections





  • Optimize multisystem abnormalities of prematurity

  • Prevent aspiration (consider RSI):

    • Conflict with sepsis/hypovolemia & hemodynamic stability

  • Anticipate & optimize fluid, electrolyte, glucose derangements

  • Ensure good IV access (or central line above the diaphragm)

  • Ensure continuous temperature monitoring & maintain normothermia

  • Correction of coagulopathy

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