Abstract
Objective: identify the frequency and the risk factors for the necrotic enterocolitis (NEC) after cardiac surgery in neonates.
Material and methods. A retrospective comparative study included 157 newborns who underwent open cardiac surgery in the period from January 20015 to December 2019.
Results. In the general group, the frequency of NEC was 7,6 %. Stage I NEC was diagnosed in 5 patients (41.6% of patients with NEC), stage II was diagnosed in 3 (25.0%), and stage III was detected in 4 (33.3%) cases. Hospital mortality was 16.5%, while among patients with NEC this indicator was significantly higher than 41.6%. In patients with birth weight < 2 kg, the chance of developing NEC increased by 1.73 times (OR 1.73; 95% CI 1.12–2.79; p = 0.039). In cases of a single ventricle of the heart, the risk of NEC increased by 9.3 times (OR 9.31; 95% CI 1.42–60.70; p = 0.018). With a gestational age of more than 38 weeks, the chance of developing NEC decreased by 63% (OR 0.61; 95% CI 0.01–0.94; p = 0.014). An increase in lactate concentration by 1 mmol / L on the 2nd and 3rd day after surgery increased the risk of developing NEC by 9% (OR 1.09; 95% CI 1.13–2.69; p = 0.02) and 18% (OR 1.18; 95% CI 1.04–3.17; p = 0.014), respectively. In the case of acidosis in the first postoperative days, the risk of NEC was 1.39 times higher (OS 1.39; 95% CI 1.11–2.09; p = 0.023). When using high doses of inotropes (inotropic score (IS) more than 10) on the 3rd day after surgery, the chance of developing NEC increased by 1.66 times (OR 1.66; 95% CI 1.48–1.90; p = 0.009)
Conclusions. Risk factors for NEC after cardiac surgery in newborns are: birth weight less than 2 kg, single ventricle of the heart, IS more than 10 on the 3rd day after surgery, lactate concentration on the second and third postoperative days, development of acidosis during the first postoperative days.
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About the authors
- Vladlen V. Bazylev, Dr. Med. Sc., Professor, Chief Physicion, ORCID
- Klara T. Shcheglova, Anesthesiologist-Intensivist,
ORCID
- Saveliy E. Shcheglov, Anesthesiologist-Intensivist, ORCID
- Anton I. Magilevets, Head of Department, ORCID
- Shakhriyar F. Suleymanov, Anesthesiologist-Intensivist, ORCID
- Aleksey E. Chernogrivov, Dr. Med. Sc., Professor, Head of Department, Cardiovascular Surgeon ORCID
