Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants

The best computerized provider order entry systems (CPOE) have decision support, and the best decision support will change as the new medical information becomes available. Calculators and other CPOE for neonatal total parenteral nutrition(TPN) is no exception and underscores the need for pediatricians and pharmacists to be actively involved in the creation and update of medical software.(1,2).The "beat goes on " with new TPN ordering systems having ranitidine as an opt in , rather than opt out TPN supplement in light of the new study by Guillet and colleagues concerning ranitidine and risk for necrotizing enterocolitis (NEC).(3)Carnitine is expensive, and may be an example of another ingredient that should be opt in, not opt out.(4,5).

References: 1.Costakos DT Of lobsters, electronic medical records, and neonatal total parenteral nutrition. Pediatrics. 2006 Feb;117(2):e328-32. 2.Lehmann CU, Conner KG , Cox JM Preventing provider errors: online total parenteral nutrition calculator. Pediatrics. 2004 Apr;113(4):748-53. 3.Guillet R, Stoll BJ , Cotten CM , Gantz M, McDonald S, Poole WK, Phelps DL for members of the National Institute of Child Health and Human Development Neonatal Research Network Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants Pediatrics 2006; 117: e137-e142 4. Kumar M, Kabra NS, Paes B Role of carnitine supplementation in apnea of prematurity: a systematic review.J Perinatol. 2004 Mar;24(3):158-63. Review. 5. Whitfield J, Smith T, Sollohub H, Sweetman L, Roe CR. Clinical effects of L-carnitine supplementation on apnea and growth in very low birth weight infants. Pediatrics. 2003 Mar;111(3):477-82.

Conflict of Interest:

None declared