Necrotizing Enterocolitis in Neonatal Intensive Care Units
A Systematic Review of Biochemical Markers and Nursing Interventions
DOI:
https://doi.org/10.36557/2009-3578.2025v11n2p8770-8795Palavras-chave:
necrotizing enterocolitis, biomarkers, neonatal nursing, diagnosis, intensive careResumo
Necrotizing enterocolitis (NEC) is a severe gastrointestinal disorder that predominantly affects premature and very low birth weight newborns, representing one of the leading causes of morbidity and mortality in neonatal intensive care units (NICUs). Its multifactorial pathogenesis and rapid clinical progression pose significant diagnostic challenges, underscoring the importance of early identification of biochemical alterations that precede overt clinical signs. In this context, the nursing team plays a fundamental role in the early recognition of physiological instability, interpretation of laboratory parameters, and implementation of evidence-based preventive and therapeutic interventions. Objective: To analyze the scientific evidence regarding the biochemical biomarkers associated with NEC and to correlate these findings with nursing interventions that contribute to early detection, prevention, and clinical management of the disease in NICUs. Methods: This systematic review followed the PRISMA guidelines. Searches were conducted in Embase, PubMed/MEDLINE, Scopus, and Web of Science in October 2025 using descriptors related to NEC, biochemical markers, and neonatal intensive care. Two independent reviewers performed screening, full-text assessment, and data extraction. Original studies involving newborns diagnosed with NEC that reported biochemical, hematological, molecular, or stool biomarkers were included. Studies addressing nursing interventions related to early identification or prevention were also considered. Conclusion: The findings indicate that no single biomarker demonstrates sufficient accuracy for early and definitive diagnosis of NEC. However, combined biochemical markers, such as CRP, IL-6, IL-8, i-FABP, calprotectin, galectin-3, and lysosomal enzymes, enhance diagnostic sensitivity and assist in identifying disease severity and prognosis. Evidence underscores the crucial role of nurses in integrating laboratory data with clinical assessment, monitoring inflammatory markers, guiding enteral feeding practices, preventing complications, and coordinating multidisciplinary care. Future research should prioritize multicenter studies integrating biochemical, molecular, and proteomic approaches to refine diagnostic precision and strengthen nursing-driven surveillance strategies in NICUs.
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Copyright (c) 2025 Aline Lima Oliveira dos Santos, Nayara Salles Goulart, Patrícia Natália Monteiro Leite, Luciana Craveiro de Paula, Ana Maria Nogueira Gomes, Juliana de Fatima da Conceição Veríssimo Lopes
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