Diarrhea in neonatal intensive care unit.
OBJECTIVE
To investigate the frequency, etiology, and current management strategies for diarrhea in newborn.


METHODS
Retrospective, nationwide study involving 5801 subjects observed in neonatal intensive care units during 3 years. The main anamnesis and demographic characteristics, etiology and characteristics of diarrhea, nutritional and therapeutic management, clinical outcomes were evaluated.


RESULTS
Thirty-nine cases of diarrhea (36 acute, 3 chronic) were identified. The occurrence rate of diarrhea was 6.72 per 1000 hospitalized newborn. Etiology was defined in 29 of 39 newborn (74.3%): food allergy (20.5%), gastrointestinal infections (17.9%), antibiotic-associated diarrhea (12.8%), congenital defects of ion transport (5.1%), withdrawal syndrome (5.1%), Hirschsprung's disease (2.5%), parenteral diarrhea (2.5%), cystic fibrosis (2.5%), and metabolic disorders (2.5%). Three patients died due to complications related to diarrhea (7.7%). In 19 of 39 patients (48.7%), rehydration was performed exclusively by the enteral route.


CONCLUSIONS
Diarrhea in neonates is a challenging clinical condition due to the possible heterogeneous etiologies and severe outcomes. Specific guidelines are advocated in order to optimize management of diarrhea in this particular setting.
Department of Pediatrics, University of Naples Federico II, Naples, 80131, Italy.
Annalisa
A
Passariello
Gianluca
G
Terrin
Maria Elisabetta
ME
Baldassarre
Mario
M
De Curtis
Roberto
R
Paludetto
Roberto
R
Berni Canani
D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies