Journ.Ped. Surgery Feb 2010 page 310- if 3 metabolic derangement were noted within 24 hours of observation then operation is better than observation. The 7 metabolic derangement were 1) positive blood culture <96 hours, 2) pH <7.25 or receiving Hco3, 3) I/T of >0.2
4) Na <130, 5) Platelets <50k and neutrophils <2000.
babies with bad outcome-death or TPn at discharge was higher if 3 or more metabolic derangement were noted.
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