303 Do Cytokine or CRP Measures Assist in the Diagnosis of Necrotising Enterocolitis: A Systematic Review

Objective: To conduct a systematic review of the use of cytokines or CRP in the diagnosis of necrotizing enterocolitis (NEC) in neonates.Methods: MEDLINE was searched (keywords: NEC, pseudomembranous enterocolitis, diagnosis, newborn, and cytokine) from 1985 through 2005. Inclusion criteria were: (i) pre-term infants younger than 90 days (ii) proven NEC defined as intramural gas on Xray or surgical findings. The MEDLINE search was repeated (using keyword CRP instead of cytokine). Data were extracted to calculate specificity and sensitivity. Two independent reviewers selected and reviewed the articles.Results: The search identified 22 potential studies, of which 5 allowed retrieval. The search identified 22 potential studies, of which 5 allowed retrieval.Conclusion: There are few studies which have examined the use of either cytokines or CRP as diagnostic tools for NEC. The possible association between NEC and cytokines is suggested in 22 studies. However, there is a lack of sufficient studies in which likelihood ratios could be calculated (n=4). Similarly, there is an insufficient number of studies which examine the use of CRP as a diagnostic tool for NEC. With the emergence of cytokines and CRP research in the last decade, studies that examine the link between cytokines and NEC should be further explored in larger cohorts. References Moore, A. 1999; Pediatr Res; 54: 114A. Ahmed, T. 1998; Pediatr Res 43:163A. McLoy, M.P. 2002. Pediatric Research. 51(6):756 Caplan, M.S. 1990 J Pediatrica 116:960 Isaacs, D. 1987 Acta Paediatr Scand 76:923