Korean Journal of Pediatrics 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 Kim1, Yi Sun Kim1, Hye Soo Yoo1, So Yoon Ahn1, Hyun ju Seo1, Seo Heui Choi1, Soo Kyung Park1, Yu Jin Jung1, Myo Jing Kim2, Ga Won Jeon3, Soo Hyun Koo4, Kyung-Hoon Lee5, Yun Sil Chang1, Won Soon 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
괴사성 장염으로 수술한 초극소저체중출생아(<1,000 g)의 예후인자 분석
김진규1, 김이선1, 유혜수1, 안소윤1, 서현주1, 최서희1, 박수경1, 정유진1, 김묘징2, 전가원3, 구수현4, 이경훈5, 장윤실1, 박원순1
1성균관대학교 의과대학 삼성서울병원 소아청소년과
2동아대학교 의과대학 소아과학교실
3인제대학교 의과대학 부산백병원 소아청소년과
4성균관대학교 의과대학 마산삼성병원 소아청소년과
5성균관대학교 의과대학 분자세포생물학교실
Won Soon Park, Tel: +82.2-3410-3523, Fax: +82.2-3410-0043, Email: wonspark@skku.edu
: 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.
: We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center.
: 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).
: Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.
Key Words: Extremely low birth weight, Necrotizing enterocolitis, Laparotomy, Prognosis

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