Necrotizing Enterocolitis
Everything in the library about necrotizing enterocolitis — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Nutritional Management
1 item
Intestinal Rehabilitation, Episode 3: Enteral Autonomy, Part 1
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We're back with a new episode from the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. This time we're talking about enteral autonomy with Drs. Helmrath and Wales. This is the first of two parts on this topic, stay tuned
podcast16:18 · Mar 2022
Surgical Management
2 items
Intestinal Rehabilitation, Episode 2: Overwhelming intestinal damage, Part 2
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We're back with the second part of episode 2, management of overwhelming intestinal damage along with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital. Article for further reading:
podcast17:21 · Feb 2022
Update Course Rewind 2025: Updates in NEC Management
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Narrated by Lizzy Lee, PA-C & Maggie Koenig, this podcast, a rewind from the 2025 Pediatric Surgery Update Course, delves into crucial updates in Necrotizing Enterocolitis (NEC) management. Leading pediatric surgeons Drs. Augusto Zani, Simo
video11:03 · Jul 2026
Complications
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Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
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Rach Mena, Gabriela Guillén, Sergio Lopez-Fernandez, Marta Martos Rodríguez, César W Ruiz, Alicia Montaner-Ramon, Manuel López, José A Molino
Background: Necrotizing enterocolitis (NEC) is one of the main causes of acute abdomen in neona
video0:50 · Jan 2025
Evidence & Research
9 items
Journal of Pediatric Surgery Article Review: October 2021
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We're back with the October issue of JPS article highlights. This time we're talking to JPS Editor Dr. Paul Tam and authors Dr. Brittany Johnson, Dr. Nigel Hall, Dr. Richard Wood, and Dr. Giacomo Esposito. Hosts: Ellen Encisco & Rod Gerardo
podcast19:10 · Nov 2021
Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema
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New article you should know about by Dr. Cecilia Gigena
"Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enem
video0:56 · Apr 2023
Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus
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Another article you should know by Cecilia Gigena
"Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus"
Authors: Tim Hundscheid, M.D., Wes Onland, M.D., Ph.D., Elisabeth M.W. Kooi, M.D., Ph.D., Daniel C. Vijlbrief, M
video1:14 · Aug 2023
Heat 3 Winner: Shruthi Srinivas, MD - Best of the Best in Pediatric Surgery 2024
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Watch the voting from the third heat!
Presentations from heat three:
Mina Yeganeh, BSc: Lipid nanoparticle delivery of miRNA-148a attenuates intestinal inflammation during experimental.
Joseph Davidson, MA(Oxon), MBBS, MRCS(Eng)
video1:47 · Feb 2024
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
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New article review by Alex Halpern, MD!
Full text: https://www.jpedsurg.org/article/S0022-3468(24)00077-0/fulltext
Background: Enteral feeding is an essential part of the management of infants with gastroschisis. We hypothesized that
video0:56 · Aug 2024
Dr. Colleen Nofi - Best of the Best in Pediatric Surgery 2025
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Watch APSA's Dr. Colleen Nofi’s presentation on “Extracellular Cirp Exacerbates Necrotizing Enterocolitis” at the 2025 Best of the Best in Pediatric Surgery event!
Moderators: Drs. Todd Ponsky, Dan von Allmen, and Meera Kotagal
video8:06 · Mar 2025
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
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Rahul Gadde, Jason Xia, Sophia Hameedi, Angela Saulsbery, Carly Schafer, Lourenço Sbragia, Oluyinka O Olutoye
Background: Necrotizing enterocolitis (NEC) remains a devastating intestinal disease that affects 5-7% of preterm neonates. Rem
video0:59 · Apr 2025
STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial
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Simon Eaton, Niloofar Ganji, Mandela Thyoka, Maher Shahroor, Augusto Zani, Hazel Pleasants-Terashita, Ali El Ghazzaoui, Jayaram Sivaraj, Stavros Loukogeorgakis, Paolo De Coppi, Sandra Montedonico, Sanja Sindjic-Antunovic, Marija Lukac, Jame
video0:57 · Apr 2025
Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis...
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Dr. Lizzy Lee from Cincinnati Children's discusses a national multidisciplinary survey on the availability and use of bowel ultrasound (BUS) for diagnosing necrotizing enterocolitis (NEC). The study found that while BUS is available in many
video0:55 · Jul 2026
Case-Based Learning
2 items
Necrotizing Enterocolitis
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Dr. Jose Prince discusses necrotizing enterocolitis. His presentation includes management techniques of peritoneal drainage, exploratory laparotomy, diagnostic laparoscopy, complete enterectomy, silo, bowel decompression, and antibiotics as
video35:06 · Nov 2018
NEC: Update Course 2013
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Dr. Jose Prince discusses necrotizing enterocolitis. His presentation includes management techniques of peritoneal drainage, exploratory laparotomy, diagnostic laparoscopy, complete enterectomy, silo, bowel decompression, and use of antibio
video34:22 · Jan 2019
In-Depth Reviews
3 items
Necrotizing Enterocolitis with Dr. Gail Besner
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Discussion between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitis
podcast46:29 · Jan 2019
Practical Approach: Intestinal Failure Innovations
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Dr. Michael Helmrath leads a discussion in alternative feeding techniques for intestinal failure, distal feeding, button insertion, the significant of small bowel length, liver disease, international patient management, breast milk therapy,
video116:52 · Jan 2019
Stay Current Throwbacks Necrotizing Enterocolitis with Dr. Gail Besner
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Today is #NECday so we went back to a conversation between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitis. Enjoy this Stay Current Throwback on NEC. https://pubmed.ncbi.nlm.nih.gov/34506326/
podcast47:54 · May 2022
Long-Term Care
1 item
Multidisciplinary Approach: Intestinal Failure Innovations
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Dr. Michael Helmrath leads a discussion amongst the panel including topics of intestinal failure, a team approach to intestinal patients, nutritional administration, complication rates, central line vs. PICC line use for total parenteral nu
video97:52 · Jan 2019
Summaries and takeaways+ Show
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Multidisciplinary Approach: Intestinal Failure Innovations
Team approach to intestinal failure reduced 1-year mortality from 30-40% to approximately 5% per year at University of Michigan
clinicalSam2:23 ↗
Cincinnati's intestinal failure program was started in 1984
clinicalSam2:51 ↗
Intestinal failure is defined by inadequate bowel length OR bowel that doesn't absorb nutrition and fluid adequately to maintain growth
clinicalMonique3:47 ↗
Almost 30% of patients leaving NICU without rotavirus vaccination were readmitted with rotavirus infection
epidemiological16:56 ↗
Joint weekly rounds with surgeons, gastroenterologists, dietitians, and neonatologists help identify protocol deviations and build family rapport
clinicalSam18:11 ↗
Breast milk provides not just immunostimulatory benefits but motility effects through oligosaccharides and healing properties
clinical30:13 ↗
PIFCON study data showing 25% mortality or transplant referral are now archaic; outcomes have improved dramatically in past 5 years
opinionSam33:36 ↗
Cincinnati reduced catheter-related bloodstream infections from 12 per 1000 catheter-days to 2 per 1000, approaching <1 per 1000
clinical37:31 ↗
Standardized central line bundles and multi-hospital communication networks have reduced line infections across pediatric populations
clinical38:54 ↗
Intestinal failure patients have unique propensity for line infections and different infection types compared to general pediatric population
clinical39:45 ↗
Toronto experience paper in JPGN examined PICC lines for TPN administration
clinical41:13 ↗
Complication-free survival of PICC lines is approximately half that of broviacs according to IR literature
clinicalSam44:58 ↗
Subclavian approach for central lines carries higher risk of stenosis compared to jugular approach
clinicalValerie46:26 ↗
Lack of vascular access is no longer a common indication for intestinal transplant in past 3 years at some centers
clinical50:04 ↗
Ethanol locks use 70% concentration with 2-6 hour dwell time, can be given 3 times weekly (Monday/Wednesday/Friday) with good results
clinicalSam60:20 ↗
Ethanol locks work better with 6.6 French catheters than smaller catheters; smaller PICC lines tend to occlude
clinicalSam61:04 ↗
Younger NPO infants often cannot tolerate TPN windows required for ethanol locks
clinicalSam61:28 ↗
UK predominantly uses taurolidine locks rather than ethanol locks for line infection prevention
clinicalGirish63:55 ↗
Line care education is crucial; recurrent infections warrant revisiting line care practices before implementing locks
clinicalGirish64:23 ↗
Fungal line infections are pulled more promptly, but some centers now treat through even fungal infections in patients with limited vascular access
clinical65:32 ↗
Phytosterols in soy-based lipids are cleared poorly, share cholesterol transporter (down-regulated by endotoxemia), and reduce FXR receptor expression causing hepatocyte damage
clinicalSam68:34 ↗
Limiting lipid intake to 1 g/kg/day reduces cholestasis rate to less than 5% of patients
clinicalSam69:42 ↗
Fish oil-based lipid (Omegaven) may have anti-inflammatory advantage and benefit patients who don't respond to lipid restriction
clinicalSam70:43 ↗
Neonatologists often maintain higher lipid doses (2-3 g/kg/day) due to concern about depriving infants of linoleic acid and affecting brain development
clinicalSam71:50 ↗
With lipid restriction protocols, cholestasis rarely emerges from Cincinnati NICU
clinical72:39 ↗
Standard metrics for essential fatty acid deficiency are based on malnourished children not on TPN, so altered triene:tetraene ratios may not apply the same way
opinion74:14 ↗
Symptomatic essential fatty acid deficiency is not seen in practice with lipid restriction protocols
clinical74:41 ↗
Higher glucose infusion rates become less efficient as caloric source and are pushed toward fatty acid and fat deposition
clinical75:16 ↗
Age-based glucose infusion rate limits: generally 15-16 in premature/infants, gradually decreasing with age
guideline75:41 ↗
Intestinal failure patients may not need to maintain 50th percentile growth; unclear what appropriate growth curve should be for this population
opinion76:04 ↗
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