{"id":3977,"date":"2023-07-03T16:45:31","date_gmt":"2023-07-03T14:45:31","guid":{"rendered":"https:\/\/blog.uchceu.es\/medicina\/?p=3977"},"modified":"2023-07-03T16:53:27","modified_gmt":"2023-07-03T14:53:27","slug":"enterocolitis-necrotizante-y-probioticos","status":"publish","type":"post","link":"https:\/\/blog.uchceu.es\/medicina\/enterocolitis-necrotizante-y-probioticos\/","title":{"rendered":"Enterocolitis Necrotizante y Probi\u00f3ticos"},"content":{"rendered":"\n

La enterocolitis necrotizante (ECN) es la urgencia vital gastrointestinal m\u00e1s frecuente en las unidades de cuidados intensivos neonatales. Se trata de una enfermedad inflamatoria aguda del intestino estrechamente ligada a la prematuridad, que aparece particularmente en aquellos reci\u00e9n nacidos prematuros menores a 32 semanas de edad gestacional y\/o con un peso al nacer inferior a 1500g. Cl\u00ednicamente, se sospecha en aquellos prematuros que presentan hinchaz\u00f3n abdominal y mala tolerancia al alimento por v\u00eda oral, pudiendo acompa\u00f1arse de sangre en heces. Su mortalidad puede alcanzar cifras de hasta el 30% en los casos severos (Figura 1). Su tratamiento incluye reposo gastrointestinal, nutrici\u00f3n por v\u00eda intravenosa y antibi\u00f3ticos de amplio espectro.<\/p>\n\n\n\n

\"\"
Figura 1. Imagen de enterocolitis necrotizante en radiograf\u00eda de abdomen. Cortes\u00eda de: Keshaw Kumar, Radiopaedia.org, rID: 91158<\/figcaption><\/figure>\n\n\n\n

Aunque los mecanismos conducentes a la ECN no son del todo conocidos, parece que podr\u00eda deberse a alteraciones en la composici\u00f3n de la flora bacteriana (microbiota) del intestino inmaduro del reci\u00e9n nacido prematuro, originando secundariamente una reacci\u00f3n inflamatoria. Es por ello que el uso de probi\u00f3ticos (microorganismos con capacidades beneficiosas para el hu\u00e9sped cuando se administran en cantidades correctas por v\u00eda oral) se plantea como una opci\u00f3n terap\u00e9utica frente a la ECN. <\/p>\n\n\n\n

Determinar la eficacia de los probi\u00f3ticos para la prevenci\u00f3n de la ECN ha sido, precisamente, el tema de trabajo escogido por nuestra alumna Mar\u00eda Concepci\u00f3n Corell<\/strong>, reci\u00e9n graduada en Medicine, para su trabajo final de grado (Determining the efficacy of probiotics for the prevention of necrotising enterocolitis in preterm neonates<\/em>). Mediante una revisi\u00f3n sistem\u00e1tica de ensayos cl\u00ednicos aleatorizados y estudios observacionales realizados en prematuros menores a 37 semanas y a 2500 gramos de peso al nacer, y publicados en los \u00faltimos 10 a\u00f1os en las bases de datos PubMed, Ebsco Host y Web of Science, se encontraron 11 estudios que comparaban la incidencia de NEC entre pacientes a quienes se administr\u00f3 probi\u00f3tico frente a placebo o ning\u00fan tratamiento. Un 50% de los estudios revel\u00f3 una reducci\u00f3n de la incidencia de NEC tras administrar probi\u00f3tico en comparaci\u00f3n con placebo o ausencia de tratamiento, lo que no descarta la posibilidad de un beneficio de los probi\u00f3ticos como profilaxis frente a NEC, aunque aboga por la necesidad de realizar m\u00e1s estudios con criterios homog\u00e9neos en cuanto a tipo de muestra y selecci\u00f3n de probi\u00f3tico. Los mayores beneficios se obtuvieron con el uso de probi\u00f3ticos resultantes de la combinaci\u00f3n de diversas cepas de bacterias, y en aquellos que inclu\u00edan especies del g\u00e9nero Lactobacillus (Figura 2).<\/p>\n\n\n\n

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Figura 2. P\u00f3ster del trabajo fin de grado durante la defensa oral. Cortes\u00eda de: Mar\u00eda Concepci\u00f3n Corell<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

La enterocolitis necrotizante (ECN) es la urgencia vital gastrointestinal m\u00e1s frecuente en las unidades de cuidados intensivos neonatales. Se trata de una enfermedad inflamatoria aguda del intestino estrechamente ligada a la prematuridad, que aparece particularmente en aquellos reci\u00e9n nacidos prematuros menores a 32 semanas de edad gestacional y\/o con un peso al nacer inferior a […]<\/p>\n","protected":false},"author":578,"featured_media":3982,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[290,291,292,294,293],"class_list":["post-3977","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nuestros-alumnos","tag-enterocolitis-necrotizante","tag-pretermino","tag-recien-nacido-prematuro","tag-revision-sistematica","tag-tfg"],"yoast_head":"\nEnterocolitis Necrotizante y Probi\u00f3ticos<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blog.uchceu.es\/medicina\/enterocolitis-necrotizante-y-probioticos\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Enterocolitis Necrotizante y Probi\u00f3ticos\" \/>\n<meta property=\"og:description\" content=\"La enterocolitis necrotizante (ECN) es la urgencia vital gastrointestinal m\u00e1s frecuente en las unidades de cuidados intensivos neonatales. 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