Neonatal supraventricular tachycardia and necrotizing enterocolitis: case report and literature review
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(2020) 46:117
CASE REPORT
Open Access
Neonatal supraventricular tachycardia and necrotizing enterocolitis: case report and literature review Federico Mecarini* , Federica Comitini, Flaminia Bardanzellu, Paola Neroni and Vassilios Fanos
Abstract Background: Necrotizing enterocolitis (NEC) and supraventricular tachycardia (SVT) are serious emergencies in the neonatal period. Although these conditions are recognized as distinct pathologies, literature reports suggest that recurrent episodes of SVT may predispose patients to NEC via disturbances in mesenteric blood flow and a decrease in tissue perfusion. Case presentation: We present a case of a preterm infant affected by recurrent episodes of SVT who developed the initial stage of NEC on the 17th day of life. Moreover, a detailed description of all the cases described in the literature is reported. Materials and methods: An integrative review of the updated literature in the Medline database and PubMed and scientific books and articles was conducted. The research from October 2019 to December 2019 was searched for with MeSH and free terms (necrotizing enterocolitis, supraventricular tachycardia) and was linked by Boolean operators. Conclusions: SVT can be considered a risk factor for the development of NEC. Therefore, clinicians should have a high level of suspicion for NEC in infants affected by SVT. This article is the first structured literature review analysing the association between SVT and NEC. Keywords: Necrotizing enterocolitis, Supraventricular tachycardia, Neonatal intensive care
Introduction Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency that mainly affects premature infants in neonatal intensive care units (NICUs). NEC is considered a multifactorial disease, and its pathogenesis is not yet completely understood. Supraventricular tachycardia (SVT) is the most common pathological tachycardia in newborns, with an estimated prevalence of up to 1 in 1000 children. SVT is a heterogeneous collection of dysrhythmias characterized as a narrow-complex tachycardia originating above the level of the AV junction [1]. SVT could originate through a mechanism of retrograde conduction * Correspondence: [email protected] Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
(reentrant tachycardia) or through atrial ectopic beats (automatic tachycardia). In the neonatal period, SVT may be asymptomatic if the episodes are brief or may present with signs of heart failure, such as poor feeding, sweating and shortness of breath, due to a prolonged episode [2]. In haemodynamically stable patients, vagal manoeuvres, such as the “diving reflex”, are the first-line nonpharmacologic therapies. If they prove ineffective, adenosine is administered. Maintenance therapy with antiarrhythmic drugs is carried out in cases of recurrent episodes, while spontaneous resolution usually occurs in the first year of life in most cases [3]. Recent data in the literature suggest a possible association bet
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