Treatment of necrotizing enterocolitis (NEC) in newborns remains an urgent problem in modern pediatric surgery and intensive care. The main reason is a large amount of septic complications and high mortality in this group of patients. In this connection, it is important to search for technologies that allow minimize quantity and severity mentioned above complications.

In the article [1] consider the actual problem of fast track in newborns with NEC. Patients were divided into two groups matched for gestational age, weight and sex of patients. The Group1 consisted of 18 infants with NEC stage 2 to 3, in which the complex treatment was provided using presacral blockade with ropivacaine. The Group 2 was represented by 17 patients with NEC stage 2–3 undergoing standard treatment program. After 16 hours from the start of treatment in the Group 1 with respect to the Group 2 there was a significant decrease in the level of pain on a CHEOPS scale (6.0±0.5 points and 9.5±0.3 points, respectively, p = 0.001). Was shown substantial and significant reduction in the dose of fentanyl in the case of surgical intervention (62±2.5 mcg and 120±3.2 mcg, respectively, p = 0.002), respectively. Staying at mechanical ventilation after surgery was also reduced (1.5±0.8 days and 3.4±1.1 days, respectively). Significantly lower level of systemic and local inflectional complications was found in the Group1. Thus, holding presacral blockades with ropivacaine is an effective method of accelerating the recovery of infants with NEC, bringing the methodology of conducting to the fast track technology.

In the article [2] the Study objective was to improving the efficiency of health care delivery to neonates with necrotizing enterocolitis (NEC). Materials and methods. During the period from 2008 to 2012 47 premature infants with NEC underwent treatment in the neonatal infectious disease ward and intensive care unit of State-financed health institution of Stavropol Region “Regional pediatric clinical hospital” (Stavropol). Transabdominal ultrasonography was performed using GE Pro series LOGIQ 500 and SonoAce PICO ultrasonography apparatus and 7.5 MHz transducer. Results. Progressive thickening of bowel wall was observed starting from 1B-stage of NEC (1.1 ± 0.3 mm). The maximum value was reported at 3B-stage of NEC (2.1 ± 0.3 mm). The apparent advantages of ultrasonography include the ability to diagnose bowel necrosis, free peritoneal fluid and hepatic portal venous gas. Conclusion. Ultrasonographic signs of early-stage NEC include the presence of free peritoneal fluid, intestinal motility pattern change, colon diameter increase and bowel wall thickening. The absence of intestinal motility and intestinal wall pneumatization are used as markers of surgical implications.

In the article [3] treated infants with NEC from 1B to 3A stages, during the double-blind controlled prospective randomized study and the period from 2012 to 2014. Boys were 12, girls – 7. Body weigh was 1996+0.2 gramms. The group 1 of 10 infants was assigned the complex treatment technique, developed by us, presacral anesthesia 0.5% sol. ropivacaine of 0.1ml/kg. The group 2 was 9 infants, was assigned with the traditional methods of complex intensive care the blockade of procaine solution 0.25% the rate of 0.5ml per administration. Determined by the concentration of substance P, cardiac output and peripheral vascular resistance at diagnosis, after 2,4,8 and 16 hours after initiation of treatment. The concentration of substance P in serum of blood of newborns with NEC corresponded to the severity of pain and was significantly higher in the group 2 compared to the group 1 to 16 hour of therapy. Presacral analgesia with ropivacaine is more efficiently and reduces the number of surgical interventions in newborns with NEC probably by reducing circulatory disorders of internal organs and systems.

In the article [4] theObjects were 106 newborns (body weight 620– 4200 g) with necrotizing enterocolitis. Diagnostic algorhythm was standard for newborns with low and extremely low body weight and also included monitoring of katelicidin LL-37 blood content. Treatment approach suggested by the authors depended on the detected level of katelicidin and allowed to reduce number surgery of cases to 19,8 %.



  1. Minaev S. V., Obedin A. N., Kachanov A.V., Annenkov M.V., Tovkan E.A., Gerasimenko I.N. FAST TRACK IN THE TREATMENT OF NEWBORNS WITH NECROTIZING ENTEROCOLITE. Meditsinskii Vestnik Severnogo Kavkaza. – Medical News of North Caucasus. 2016;11(2):152-155. doi: 10.14300/mnnc.2016.11023
  2. Minaev S. V., Isaeva A. V., Tovkan E. A., Zagumennaya I. Y., Kachanov A. V., Filipeva N. V. Ultrasound diagnosis in infants with necrotizing enterocolitis. Doctor.Ru. 2014;3(91):31-33.
  3. Obedin A. N., Kachanov A. V., Annenkov M. V., Tovkan E. A., Kiriyenko O. S. Necrotizing enterocolitis in newborns. Do we all do to save their patients? Meditsinskii Vestnik Severnogo Kavkaza. – Medical News of North Caucasus. 2015;10(2):140-143. doi: 10.14300/ mnnc.2015.10026
  4. Minaev S. V., Tovkan E. A., Kachanov A. V., Isaeva A. V.  An improvement of treatment newborns optimization of management of necrotizing enterocolitis in newborns. Meditsinskii Vestnik Severnogo Kavkaza. – Medical News of North Caucasus. 2013;8(3):30-34. doi: 10.14300/mnnc.2013.08007




  1. Igor9551 says:

    НЭК- очень большая проблема. Скажите, у Вас есть протокол ведения НЭК? И как часто, Вы встречаетесь с этой проблемой?

    • В настоящее время количество детей с НЭКами увеличилось. Мы придерживаемся тактики ведения пациентов согласно общепризнанных подходов, на основании которых нами был разработан и применяется протокол ведения пациентов с НЭК

Leave a Reply