ECMO-/ECLS

Stage IIB: moderately ill with systemic toxicity including acidosis,

thrombocytopenia, or ascites

Stage III (advanced NEC)^

Critically ill with

Stage IIIA:Stage IIIB: (^) proven intestinal perforationimpending intestinal perforation
When evaluating a patient with NEC, look for these conditions

1. History: EGA, history of enteral feeds, PDA, UVC, UAC, indomethacin administration.
   2 Exam: VS (tachycardia, bradycardia, hypotension), abdominal tenderness, abdominal
   discoloration. Note that abdominal discoloration may be an ominous sign for intestinal
   necrosis.


2. Lab work: Platelet count, ABG


3. KUB: 2 views of abdomen are necessary to thoroughly evaluate abdomen for free air.
   Findings may include:

Fixed, dilated loop of bowel

Pneumatosis intestinalis

Sub-mucosal: bubbly

Sub-serosal: linear

Portal venous gas

Free air in abdomen

Classically above liver on LLD view

May see round lucency over mid-abdomen on KUB (“football sign”)

Outlined falciform ligament on Xray indicates free air