1173 Application of high-resolution physiological data in necrotizing enterocolitis management: a literature review. (17th August 2022)

• Record Type: Journal Article
• Authors: Schaffer, Sierra; Eaton, Simon; Costa, Cristine Sortica Da
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A186
• Page End: A186
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.297
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: Necrotizing enterocolitis (NEC) is a serious condition with high morbidity and mortality that is most common in premature neonates. As survival rates of premature births are rising overall, so is the prevalence of NEC. Its pathophysiology is complex and not yet fully understood, and this makes preventive care and early intervention difficult. This literature review aimed to investigate new technology and techniques with high-resolution physiological data and establish how they might be used to enable early intervention and predict surgical requirements when managing NEC patients. Methods: A literature review was conducted on Pubmed, MedlineOvid, and TRIP databases using search terms: NEC, management, treatment, and surgery. The search was limited to English language and full articles. A scoping review of grey literature was also conducted in order to include research conducted on the use of high-resolution physiological data in other conditions. Results: NEC is currently managed according to clinician's judgment and Bell's modified staging criteria, 1 of which physiological observations hold significant weight. There is a lack of quantitative guidelines to support management decisions, which reflects the variability of NEC cases. By utilizing high-resolution physiological data, that complexity is reflected and can be analyzed quantitatively. The benefit to this would be a definitive evidence-based management plan and the ability to predict the need for surgical intervention, potentially limiting morbidity and mortality. While the perceived advantages of utilizing high-resolution physiological data in NEC are made clear in many studies, there is a lack of research and data to support this. This type of data has been successfully utilized in other areas of neonatology and healthcare overall, and it is reasonable to extrapolate that it may also be successful when applied to NEC management. Current research has determined that both variability and trends within physiological data are valuable when predicting outcomes. It has also been shown that increasing the number of variables and defined relationships between those variables is most likely to yield accurate outcomes; however, this increases the infrastructure and processing time required and is best accomplished when cognitive computing technology is applied. With challenges surrounding the development of cognitive computing technology to support the analysis and pattern recognition of NEC data, combined with the lack of established databases, there are significant barriers that still need to be overcome in order to fully investigate and realize the potential of high-resolution physiological data. Conclusion: High-resolution physiological data is a relatively new medium to work with and requires extensive infrastructure and processing before yielding tangible outcomes. Early studies on the use of high-resolution physiological data in neonatal conditions reflect this potential. Due to the complexity and variability of NEC this detailed insight is particularly valuable, however further research as proof of concept is needed. Reference: Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al . Neonatal Necrotizing Enterocolitis. Annals of Surgery . 1978 Jan;187 (1):1–7.