You've diagnosed NEC- NOW what do you do???- Tala Talks NICU

NPO? Replogle to suction? Serial KUBs? Which antibiotics? When does a patient need surgery? Learn all this in part 3 of the series on NEC. Management and Treatment of NEC - Tala Talks NICU
---------------------------------------------------------------------

Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded!

---------------------------------------------------------------------

Dr. Tala is a board-certified neonatologist, and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.

----------------------------------------------------------------------
References:
Acute Necrotizing Enterocolitis in infancy: A review of 64 cases. Santulli et al. Pediatrics vol. 55 No. 3 March 1975

Antibiotic Treatment and Patient Outcomes in Necrotizing Enterocolitis. Murphy et al. Am J Perinatol 2020 Oct;37 (12) 1250-1257

Initial Laparotomy versus Peritoneal Drainage in Extremely Low Birthweight Infants with Surgical Necrotizing Enterocolitis or Isolated Intestinal Perforation. Blakeley et. al. Annals of Surgery. Volume 274. Number 4. Oct 2021.
-----------------------------------------------------------------------
Timstamps:
0:55 Management of NEC
2:00 Treatment of NEC
7:31 When is surgery required for NEC?
9:30 Which surgical intervention should be chosen?
13:07 Second look
13:42 Supporting other systems while an infant has NEC
15:14 When do we stop treatment?
----------------------------------------------------------------------------
----------------------------------------------------------------------------
*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

[anneshields]

I have worked with many neonatogists in my career. All have the gift of healing. Not all have the gift of explaining. You have both. Thank you for all your teaching.

[inalumieresonia]

I am a general pratictionner but your videos inspire me to become one day a neonatologist!

[naitramsingh]

Amazing video as always, very informative and you are an awesome teacher, do continue the amazing work, thank you and your team

[MoHa-dpwd]

I would add that you should make sure you have a negative blood culture for 24-48 hrs prior to placing a central line.
Recently, on a baby we had with NEC we did 10days of Amo/Gent/Clinda, due to a nasty X-ray and concern for a perf. We could have considered stopping the Clinda once the baby was stable and X-ray cleared, but didn’t. We did start feeding on day 7 of treatment and was able to pull the central line out the day we stopped abx.

[freedaboyoung]

Thank you so much, Dr Tala! Wonderful video as always

[brandonbaker]

1 of my twin sons had NEC diagnosed when he was about 10 days old. They didn't hesitate and did a stoma surgery right away, because they found a preforation. He's 9 months old now and will have stoma reversal surgery tomorrow. He has done so well with an ostomy bag. Hes gained weight and is just as big as his brother without NEC.

I'm praying his surgery goes well. He is not in the US with me, but in Colombia South America with his mom. I hope this 2nd bowel surgery will be his last, and he'll live a normal life.

Any advice?

[shellyshahaf]

really love your videos
i work in a hospital in tel aviv - Israel. we use tazocin for 5-7 days. i never knew about the drainage you were talking about. in some cases babies get surgery with stoma.
thank you very much!
glad i discovered your channel

[lvillarreal]

Thank you, Dr Tala! Do you think you can discuss and elaborate lab results (computations) in identifying infection in newborns. Such as bands/segs etc. If possible.

[aquidox]

So glad to come across your videos on NEC, what are your thoughts on probiotics in regards to strengthening premature gut biomes? Is this considered complimentary to everything else you've mentioned?

[docNICU]

in our unit the peritoneal drain used only for those babies with surgical NEC who are very very sick like shock, on multiple ionotropic support and are otherwise not fit for exp lap and will ultimately go for exploration if they survive.
the main question always is regarding how many days the patient has to be kept without feed and free drainage OGT because majority of the cases are ?NEC or and no one is sure weather this is stage 1 NEC or somthing else and unfortunately we dont have any clear guidelines for that.

[baghdai]

I am a plastic surgeon. My daughter in law gave birth at 27 weeks to twins aboy and girl. 700gm and 1kg weight. Both Wer Suspdcted to have NEC. the girl was opemn and shut case . No finding of necrosis. The boy had NEC. 2cm removed and stoma closed few days ago. The girl is growing up but the boy is noing as good. What are the chaces that he will be disabled

[goecmj]

Can you highlight the difference btwn a mucous fistula and an ostomy?

[محبةالرحمن-مح]

When to start vancomycin ornafacilin it wasnt clear for me