Recommendations for management may include:
NPO for 7-14d
Ampicillin, Gentamicin, and Flagyl for 7-14d
Considere prophylactic antifungal (Fluconazole)
Repogle to low intermittent suction to decompress the abdomen
Q 6-8 hr 2-view abdominal X-rays (esp. during 1st 24 hrs of diagnosis).
Monitor CV status and blood gases IVF/volume expanders
Consider NIRS
(^) Operative intervention is necessary if there is free air on Xray, (maybe)
abdominal discoloration, fixed loop of intestine on several X-rays, clinical
deterioration/non-improvement.
To drain or not to drain? The type of operation performed for perforated
necrotizing enterocolitis does not influence survival or other clinically important early
outcomes in preterm infants. (ClinicalTrials.gov, NCT00252681.), Moss et al NEJM