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Brief Report
Peer-Review Record

Blood Glucose, Lactate and Platelet Count in Infants with Spontaneous Intestinal Perforation versus Necrotizing Enterocolitis—A Pilot Study

Children 2023, 10(6), 1028; https://doi.org/10.3390/children10061028
by Jacky Herzlich 1,2,*, Dror Mandel 1,2, Ronella Marom 1,2, Rafael Mendelsohn 1,2, Audelia Eshel Fuhrer 3 and Laurence Mangel 1
Reviewer 1: Anonymous
Reviewer 2:
Children 2023, 10(6), 1028; https://doi.org/10.3390/children10061028
Submission received: 17 March 2023 / Revised: 9 May 2023 / Accepted: 6 June 2023 / Published: 8 June 2023
(This article belongs to the Special Issue Advances in NICU Health Care)

Round 1

Reviewer 1 Report

This is a case control study that compared biomarkers (Glucose, lactate and platelet counts) among infants with a diagnosis of spontaneous intestinal perforation versus necrotizing enterocolitis

 

1)The sample size of the study (32 infants) would majorly limit inferences from such an analyses.

2)The authors could have matched the 16 cases of SIP with the 163 infants with NEC in a 1:3 or 1:4 ratio to utilize available information.   Excluding 147 cases of NEC in this analysis at the cost of  1;1 case control match has lead to serious selection bias in this study.

3)The interpretations from logistic regression analysis may be incorrect. “The odds of  SIP is reduced as the lactate level increases” is one such example.  Commonly for such analysis, the reference group has to be infants with feed intolerance or suspected SIP/NEC.

Since the authors have compared SIP with a more serious condition such as NEC, they have ended up interpreting it in this manner,which can be misleading.

 

4) As a clinician , I would be interested in knowing if biomarkers can aid in differentiating a) surgical NEC from medical NEC and  b) SIP from less severe abdominal pathologies. That would help in picking up serious intestinal pathologies at the earlier stage to institute definitive treatment

 

5)There is no information on the  lactate, glucose and platelet count at baseline in the study patients.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

In this study the authors evaluated the possibility of finding indicators to direct the diagnosis towards SIP or NEC. The aim is good.

Line 66: for data better two investigators and after averaging between them

Line 75: explain NICU

Line 84: why Appropriate, small and large for gestational age newborns (AGA, SGA, LGA) were defined according to the Israeli-specific intrauterine growth charts? Not International?

Line 101-103: write better, not easy to understand, flow diagram is better

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Ok

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