What is the treatment for mild (Bell stage II) necrotizing enterocolitis (NEC)?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Answer

Patients with mild (Bell stage II) NEC require gastrointestinal rest to facilitate resolution of the intestinal inflammatory process. These babies are traditionally kept on a diet of nothing by mouth (NPO) for 7-10 days, making parenteral hyperalimentation necessary. Many of these babies have difficult intravenous (IV) access. Therefore, the need for prolonged parenteral nutrition frequently requires placing central venous catheters, which have attendant risks and complications that include thromboembolic events and nosocomial infections.

In a Cochrane review of 15 studies comprising 979 infants, investigators found similar safety and efficacy between newer lipid emulsions (LE) from alternative lipid sources with reduced polyunsaturated fatty acid (PUFA) content and that of conventional pure soybean oil–based LEs that have high PUFA content for the parenteral nutrition of preterm infants. [38]  There were no statistically significant differences in clinically important outcomes including death, growth, bronchopulmonary dysplasia, sepsis, retinopathy of prematurity of stage 3 or higher, and parenteral nutrition–associated liver disease with the use of newer alternative LEs versus the conventional pure soy oil–based LEs.


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