Influence of Physiologic Factors and Clinical Interventions on Necrotizing Enterocolitis in Preterm Infants

2.50
Hdl Handle:
http://hdl.handle.net/10755/163436
Category:
Abstract
Type:
Presentation
Title:
Influence of Physiologic Factors and Clinical Interventions on Necrotizing Enterocolitis in Preterm Infants
Author(s):
Gregory, Katherine E.
Author Details:
Katherine E. Gregory, RN, PhD (c), Doctoral Student, Boston College Nursing, Chestnut Hill, Massachusetts, USA, email: katherine.gregory.2@bc.edu
Abstract:
Purpose: The purpose of this study is to improve the understanding of necrotizing enterocolitis (NEC) in the preterm infant population. The research aims to guide multidisciplinary neonatal intensive care teams seeking to decrease the incidence of NEC through analysis of the interrelationships between biodemographic variables, physiologic factors, and clinical interventions in the context of the preterm gut. Theoretical Framework: The findings of this study are informed by a critical care nursing perspective, which is grounded in the knowledge of physiologic homeostasis and structural integrity. This framework considers the integrated nature of biodemographic variables, physiologic factors, and clinical interventions that characterize the preterm infant population. Methods (Design, Sample, Setting, Measures, Analysis): This retrospective, predictive case controlled study used data collected from the medical records of 247 preterm infants born at New England Medical Center during 1997-2003. In this matched sample, multivariate analysis techniques were used to differentiate preterm infants who developed NEC from those who did not develop NEC. Results: Logistic regression indicated that an increase in respiratory support required to maintain oxygenation, a change in the nutritional fortification added to enteral substrate administered to preterm infants, and enteral feeding advancement > 20ml/kg/day were significant factors in predicting NEC among this preterm infant population. The odds of NEC were 16.6 times greater in preterm infants who required an increase in respiratory support (p=.000), 6.9 times greater in infants who had a change in nutritional fortification administered (p=.000), and 3.2 times higher in infants who had enteral feedings advanced > 20ml/kg.day (p=.016). Conclusions and Implications: NEC has emerged as the most common neonatal gastrointestinal emergency in many countries of the world. These results emphasize the importance of studying this elusive disease with a multidisciplinary focus on the interrelationships between neonatal clinical interventions necessary to maintain physiologic stability during the early critical care period and sound preterm infant nutrition necessary for later growth and development.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
18th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Cherry Hill, New Jersey
Description:
�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jersey
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleInfluence of Physiologic Factors and Clinical Interventions on Necrotizing Enterocolitis in Preterm Infantsen_GB
dc.contributor.authorGregory, Katherine E.en_US
dc.author.detailsKatherine E. Gregory, RN, PhD (c), Doctoral Student, Boston College Nursing, Chestnut Hill, Massachusetts, USA, email: katherine.gregory.2@bc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163436-
dc.description.abstractPurpose: The purpose of this study is to improve the understanding of necrotizing enterocolitis (NEC) in the preterm infant population. The research aims to guide multidisciplinary neonatal intensive care teams seeking to decrease the incidence of NEC through analysis of the interrelationships between biodemographic variables, physiologic factors, and clinical interventions in the context of the preterm gut. Theoretical Framework: The findings of this study are informed by a critical care nursing perspective, which is grounded in the knowledge of physiologic homeostasis and structural integrity. This framework considers the integrated nature of biodemographic variables, physiologic factors, and clinical interventions that characterize the preterm infant population. Methods (Design, Sample, Setting, Measures, Analysis): This retrospective, predictive case controlled study used data collected from the medical records of 247 preterm infants born at New England Medical Center during 1997-2003. In this matched sample, multivariate analysis techniques were used to differentiate preterm infants who developed NEC from those who did not develop NEC. Results: Logistic regression indicated that an increase in respiratory support required to maintain oxygenation, a change in the nutritional fortification added to enteral substrate administered to preterm infants, and enteral feeding advancement > 20ml/kg/day were significant factors in predicting NEC among this preterm infant population. The odds of NEC were 16.6 times greater in preterm infants who required an increase in respiratory support (p=.000), 6.9 times greater in infants who had a change in nutritional fortification administered (p=.000), and 3.2 times higher in infants who had enteral feedings advanced > 20ml/kg.day (p=.016). Conclusions and Implications: NEC has emerged as the most common neonatal gastrointestinal emergency in many countries of the world. These results emphasize the importance of studying this elusive disease with a multidisciplinary focus on the interrelationships between neonatal clinical interventions necessary to maintain physiologic stability during the early critical care period and sound preterm infant nutrition necessary for later growth and development.en_GB
dc.date.available2011-10-27T11:07:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:07:33Z-
dc.conference.date2006en_US
dc.conference.name18th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationCherry Hill, New Jerseyen_US
dc.description�New Momentum for Nursing Research: Multidisciplinary Alliances�, held on April 20th -22nd at the Hilton in Cherry Hill, New Jerseyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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