Necrotizing Enterocolitis
Considerations
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Premature infant considerations
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↑ risk of aspiration:
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Bowel obstruction, dilated bowel loops, pneumatosis intestinalis
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Associated multisystem derangements:
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Hypoxia
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Sepsis, hypovolemia
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DIC, thrombocytopenia
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Metabolic acidosis
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Associated conditions:
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Birth asphyxia, hypotension, respiratory distress syndrome, patent ductus arteriosus, recurrent apnea, intestinal ischemia, systemic infections
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Goals/Conflicts
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Optimize multisystem abnormalities of prematurity
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Prevent aspiration (consider RSI):
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Conflict with sepsis/hypovolemia & hemodynamic stability
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Anticipate & optimize fluid, electrolyte, glucose derangements
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Ensure good IV access (or central line above the diaphragm)
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Ensure continuous temperature monitoring & maintain normothermia
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Correction of coagulopathy