What is the role of abdominal decompression in the treatment of 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

Decompression is essential at the first sign of abdominal pathology. Abdominal decompression in infants with necrotizing enterocolitis is as follows:

  • Use a large-bore catheter with multiple side holes and a second lumen to prevent vacuum attachment to the stomach mucosa (eg, Replogle tube)
  • Set the catheter for low, continuous or intermittent suction and monitor output; the tube should be irrigated with several milliliters of normal saline to maintain patency
  • If copious amounts of gastric/intestinal secretions are removed, consider IV replacement with a physiologically similar solution; maintaining electrolyte balance and intravascular volume is essential

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