Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Jun 7, 2010; 16(21): 2664-2668
Published online Jun 7, 2010. doi: 10.3748/wjg.v16.i21.2664
Diarrhea in neonatal intensive care unit
Annalisa Passariello, Gianluca Terrin, Maria Elisabetta Baldassarre, Mario De Curtis, Roberto Paludetto, Roberto Berni Canani
Annalisa Passariello, Gianluca Terrin, Roberto Paludetto, Roberto Berni Canani, Department of Pediatrics, University of Naples “Federico II”, Naples, 80131, Italy
Maria Elisabetta Baldassarre, Department of Evolutive Age Biomedicine, University of Bari, Bari, 70124, Italy
Mario De Curtis, Neonatal Care Unit, University La Sapienza, Rome, 00161, Italy
Roberto Berni Canani, European Laboratory for Investigation on Food-Induced Diseases, University of Naples “Federico II”, Naples, 80131, Italy
Author contributions: Berni Canani R, Passariello A and De Curtis M designed the study; Berni Canani R and Passariello A coordinated the research team and wrote the first draft of the report; Paludetto R and Baldassarre ME were responsible for patient records and contributed to the final version of the report; Terrin G performed the data analysis, contributed to the design of the study, elaborated the computer-generated randomisation list and performed statistical analysis.
Correspondence to: Roberto Berni Canani, MD, PhD, Department of Pediatrics, University of Naples “Federico II”, Via S. Pansini, 5, Naples, 80131, Italy.
Telephone: +39-81-7462680 Fax: +39-81-7462680
Received: May 20, 2009
Revised: April 1, 2010
Accepted: April 8, 2010
Published online: June 7, 2010

AIM: 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.

CONCLUSION: 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.

Keywords: Chronic diarrhea, Congenital diarrhea, Food allergy, Oral rehydration solution, Rotavirus