Fellow Cleveland Clinic Children's Beachwood, Ohio, United States
Background: Spontaneous intestinal perforation (SIP) is a life-threatening condition in extremely low birth weight (ELBW) infants ( < 1000 g), often presenting without clear early indicators. Early signs like electrolyte imbalances, including hyponatremia, changes in potassium, magnesium and chloride levels, and increased nucleated red blood cells (NRBC), may indicate underlying stress or hypoxia that precedes SIP. This study aims to investigate changes in electrolyte levels and NRBC as potential predictive markers for SIP, exploring trends over time and their relation to the timing of SIP onset. Objective: To investigate hyponatremia, NRBC, and other electrolyte abnormalities as potential predictive markers for SIP in ELBW infants, analyzing trends over time and examining their relationship with the timing of SIP onset. Design/Methods: Retrospective 1:2 matched case-control study. Study Population: Cases: ELBW infants diagnosed with SIP within 7 days. Controls: ELBW infants without SIP, matched 1:2 based on gestational age, birth weight, and sex. Inclusion Criteria: Birth weight < 1000 g, confirmed SIP for cases, available lab data on sodium, potassium, calcium, chloride, and NRBC levels. Exclusion Criteria: NEC diagnosis, congenital anomalies affecting GI or metabolic function. Data Collection: Data from records will include birth weight, gestational age, sex, Apgar scores, ventilation support, feeding regimen, and lab values (sodium, potassium, calcium, chloride, phosphorus, magnesium and NRBC in the first week of life or closest available data). timing of SIP diagnosis for cases will be recorded. Data Analysis: Baseline characteristics for cases and controls will be summarized, followed by paired comparisons of electrolyte and NRBC levels to identify significant differences. We will assess whether changes in these laboratory markers are associated with SIP onset and analyze trends in electrolyte and NRBC levels leading up to diagnosis. We will collect the data by end of December and would perform data analysis in January we will have the abstract by February- March.
