Purpose

Necrotizing enterocolitis (NEC) totalis is a devastating disease of the newborn intestine. A precise clinical definition of the extent of gastrointestinal involvement is lacking in the existing literature, and the clinical outcomes are typically viewed as grim.

Methods

Herein, we present a series of clinical case examples of patients with varying degrees of NEC totalis and other co-morbid conditions, with possible anticipated outcomes based on current data.

Results

We define the key ethical issues and provide a framework and discussion of the ethical issues involved in the care of patients with NEC totalis and recommendations of how to approach discussions with the family of these patients We discuss the ethical considerations for both the providers caring for these patients, and the patient's family members.

Conclusion

The management of patients with NEC totalis is complex and ethically challenging.

Level of evidence

V

中文翻译：

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新生儿坏死性小肠结肠炎治疗中的伦理困境

目的

坏死性小肠结肠炎 (NEC) 全肠炎是新生儿肠道的破坏性疾病。现有文献中缺乏对胃肠道受累程度的精确临床定义，临床结果通常被认为是严峻的。

方法

在此，我们提出了一系列具有不同程度 NEC 总病和其他合并症的患者的临床案例，以及基于当前数据的可能预期结果。

结果

我们定义了关键的伦理问题，并提供了一个框架和讨论涉及 NEC 患者护理的伦理问题，以及如何与这些患者家属进行讨论的建议 我们讨论了照顾这些患者的提供者的伦理考虑患者，以及患者家属。

结论

NEC 全病患者的管理是复杂的并且在伦理上具有挑战性。

证据级别

五