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You are the neonatal ST5 and are doing the neonatal ward round. You have just seen a very well 3-week-old ex-30-week neonate who has been treated conservatively for necrotising enterocolitis (NEC) overnight. He has been kept nil by mouth, on triple antibiotics and is now screaming in hunger. You remember hearing something about faecal calprotectin (FC) being used to diagnose NEC and wonder if this is a viable option in assessing this patient.
Structured clinical question
In neonates with suspected NEC (population), does a low FC (Intervention) rule out the diagnosis of NEC (Outcome) more accurately than standard clinical evaluation (Comparison)?
A literature search was performed using Cochrane, TRIP Database, EMBASE (1974–present) and PubMed. Search terms were ‘calprotectin’, ‘neonates’ and ‘necrotizing enterocolitis’. The search was limited to English language papers. Twenty-five articles were identified. Of these, ten were excluded as they were not relevant, one paper was not available and one was a summary report only. Six of the reports identified were abstract only (of these, three had extractable data, two had no extractable data and one was excluded as it reported the same data set as Reisinger et al).1 The references of these articles and the linked articles were searched and reviewed where appropriate. Seven studies were included and reviewed in detail. These papers and the abstracts with extractable data are summarised in table 1.
These 10 studies described 632 patients in whom FC was measured and compared in neonates with NEC and those who did not have NEC. There was a reasonable amount of heterogeneity among the studies included in terms of the number of neonates studied, the …