Kempley and Gamsu listed risk factors for neonatal necrotizing enterocolitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from King's College Hospital in London.
Risk factors for neonatal necrotizing enterocolitis include:
(1) chronic intrauterine hypoxia
(2) birth asphyxia
(3) apnea
(4) umbilical artery catheterization
(5) respiratory distress and mechanical ventilation
(6) patent ductus arteriosus
(7) polycythemia
(8) hypoglycemia
(9) hypothermia
(10) other causes of hypoxia
where:
• Localized microthromboemboli were not mentioned but would also explain mesenteric ischemia.
Possible mechanisms for intestinal injury:
(1) ischemia from reduced oxygen delivery (direct effect)
(2) preferential shunting of blood from intestine to preserve brain perfusion ("diving reflex").
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