Variable management strategies for NEC totalis: a national survey.
Chi-Square Distribution
Combined Modality Therapy
Cross-Sectional Studies
Enterocolitis, Necrotizing
/ diagnosis
Health Care Surveys
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
/ diagnosis
Laparotomy
/ statistics & numerical data
Neonatologists
Practice Patterns, Physicians'
/ statistics & numerical data
Risk Factors
Surgeons
Ultrasonography
United States
Journal
Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
15
03
2019
accepted:
30
05
2019
revised:
17
05
2019
pubmed:
3
8
2019
medline:
17
7
2020
entrez:
3
8
2019
Statut:
ppublish
Résumé
Necrotizing enterocolitis (NEC) is a serious disease linked to prematurity. A variant, NEC totalis, is associated with nearly 100% mortality. There is wide variation in counseling practices for NEC totalis. Our objectives are to determine what treatment options, if any, are offered to families, and which factors influence these decisions. An anonymous survey was distributed to members of the AAP Sections on Neonatal-Perinatal Medicine and Pediatric Surgery. Data were analyzed utilizing chi-square tests and Spearman correlations, where applicable. In the setting of NEC totalis, 90% of the 378 respondents viewed offering life-sustaining interventions (LSI) as ethically permissible and 87% felt that transfer to another center willing to provide LSI should be considered; however, only 43% reported offering LSI to families. Management of NEC totalis remains challenging and significant practice variability persists. Most respondents do not offer ongoing medical/surgical management, despite believing it is an ethically permissible option.
Sections du résumé
BACKGROUND/OBJECTIVES
Necrotizing enterocolitis (NEC) is a serious disease linked to prematurity. A variant, NEC totalis, is associated with nearly 100% mortality. There is wide variation in counseling practices for NEC totalis. Our objectives are to determine what treatment options, if any, are offered to families, and which factors influence these decisions.
METHODS
An anonymous survey was distributed to members of the AAP Sections on Neonatal-Perinatal Medicine and Pediatric Surgery. Data were analyzed utilizing chi-square tests and Spearman correlations, where applicable.
RESULTS
In the setting of NEC totalis, 90% of the 378 respondents viewed offering life-sustaining interventions (LSI) as ethically permissible and 87% felt that transfer to another center willing to provide LSI should be considered; however, only 43% reported offering LSI to families.
CONCLUSIONS
Management of NEC totalis remains challenging and significant practice variability persists. Most respondents do not offer ongoing medical/surgical management, despite believing it is an ethically permissible option.
Identifiants
pubmed: 31371831
doi: 10.1038/s41372-019-0448-0
pii: 10.1038/s41372-019-0448-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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