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Clinical Case: Probiotics, Prebiotics, and Preemies

Clinical Case: Probiotics, Prebiotics, and Preemies

Format

Patient Case Study

Time to Complete

15 minutes

Released

April 15, 2019

Expires

April 14, 2020
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Maximum Credits

0.25 / AMA PRA Category 1 CreditTM
0.25 / CNE Contact Hour
0.25 / CPEU for Registered Dietitians (RDs) and Dietetic Technicians, Registered (DTRs)

Accredited Provider

Jointly provided by Haymarket Medical Education (HME) and AKH Inc., Advancing Knowledge in Healthcare

Commercial Supporter

Supported by an educational grant from Abbott Nutrition

Program Description

The most common gastrointestinal emergency faced by premature infants, necrotizing enterocolitis (NEC) is associated with serious consequences: 20% to 40% of all affected infants will require surgery and between 15% and 30% will die from the condition. Neonates who survive NEC are left at increased risk for serious problems, including short gut syndrome, strictures, and neurodevelopmental impairment.

In addition to prematurity, risk factors for NEC include being fed with formula rather than human milk and early use of antibiotics, especially if prolonged. Recent understandings have also implicated the fact that the preterm infant’s gut microbiome has fewer bacterial species, less diversity, and greater proportions of potential pathogens. This dysbiosis is now seen as a major contributor to NEC and has led to enhanced interest in supplying prebiotics and probiotics to premature infants to restore microbiome health.

This case study examines care decisions for a preterm, very-low-birthweight infant with NEC, from birth to care in the NICU, up to the time of discharge home. Considerations for optimizing the ongoing health and development of the neonate are explored in detail, as is the importance of nutritional support. The most recent data on the roles of probiotics and prebiotics in preventing and managing NEC are discussed, along with the implications of these data for routine clinical practice.

Intended Audience

NICU healthcare providers including neonatologists, pediatricians, NICU nurses, nurse practitioners and physician assistants, registered dietitians, and other healthcare providers who care for preterm infants.

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Describe the factors that contribute to the development of necrotizing enterocolitis (NEC)
  • Review strategies for the prevention and treatment of NEC
  • Employ updated clinical trial data and real-world experience on the effectiveness of probiotic and prebiotic products for the prevention and management of NEC and the improvement of overall health

Disclosure of Conflict of Interest Policy

In accordance with the ACCME Standards for Commercial Support, HME and AKH require that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME and AKH resolve all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational activities.

Faculty

David Adamkin, MD
Department of Pediatrics
University of Louisville
Louisville, KY

Dr. Adamkin has no relevant financial relationships to disclose.

Accredited Provider Disclosure

Susan Basilico and Krista Sierra of Haymarket Medical Education, the staff of AKH and Dorothy Caputo, MA, BSN, RN, Lead Nurse Planner of AKH Inc., Advancing Knowledge in Healthcare have no relevant financial relationships to disclose.

Credit

0.25

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

Haymarket Medical Education designates this enduring material for a maximum of 0.25 AMA PRA Category 1 CreditTM  . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credit

0.25

Type

CNE Contact Hour(s)

Accreditation Statement

AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Designation Statement

This enduring activity is awarded 0.25 contact hours for nurses.

Credit

0.25

Type

CPEU Credit

Accreditation Statement

AKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR).

Designation Statement

Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 0.25 continuing professional education unit (CPEU) for completion of this program/material. CDR Accredited Provider #AN008.

Additional Credit Information

Physician Assistant Continuing Education
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM  from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.25 Category 1 Credit for completing this activity.

Nurse Practitioner Continuing Education
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM  from organizations accredited by ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

Disclosure of Unlabeled Use

This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME/CE activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient's medical condition.

Disclaimer

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Haymarket Medical Education or AKH Inc., Advancing Knowledge in Healthcare. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

If you have any questions relating to the accreditation of this activity, please contact HME at cmequestions@haymarketmedical.com.

If you have any questions relating to the CE accreditation of this activity, please contact AKH at jgoldman@akhcme.com.

If you have any questions relating to your certificate or have other issues with this activity, please contact myCME.Support@haymarketmedical.com.

Instructions

To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

SYSTEM REQUIREMENTS

Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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