Correlation of Abdominal RSO2 with Superior Mesenteric Artery Velocities in Preterm Infants

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2013 Feb 9

PMID 23392317

Citations 21

Authors

M Gillam-Krakauer

C M Cochran

J C Slaughter

S Polavarapu

S J McElroy

M Hernanz-Schulman

B Engelhardt

Affiliations

Soon will be listed here.

Abstract

Objective: Near-infrared spectroscopy (NIRS) is used to monitor brain and kidney perfusion in at-risk premature and term neonates. Although NIRS holds potential for bedside monitoring of intestinal perfusion, there is insufficient evidence showing correlation with mesenteric blood flow. To determine if an association exists between abdominal regional oxygen saturation (A-rSO2) and mesenteric blood flow, we compared changes in A-rSO2 to changes in blood flow velocity in the superior mesenteric artery (SMA) before and after feedings in very-low birthweight infants.

Study Design: A-rSO2 was continuously monitored midline below the umbilicus for 3 days in 18 stable 25 to 31 week bolus-fed infants (median BW 1203 g, median age 5 days). We compared change in SMA velocity from immediately before to 10 min and 60 to 120 min after feeding with change in A-rSO2 over the same time. Spearman's rank correlation was used to ascertain if a significant association existed.

Result: Change in A-rSO2 was significantly associated with change in systolic, diastolic, and mean SMA velocity from fasting to 60 to 120 min after feeding (P=0.016, 0.021, 0.010) and from 10 min after a feed to 60 to 120 min after feeding (P=0.009, 0.035, 0.032).

Conclusion: In very preterm infants, A-rSO2 reflects blood flow in the SMA and can provide non-invasive continuous monitoring of intestinal perfusion. Further studies are indicated to determine the sensitivity of NIRS to detect early intestinal pathology in this population.

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References

Fang S, Kempley S, Gamsu H . Prediction of early tolerance to enteral feeding in preterm infants by measurement of superior mesenteric artery blood flow velocity. Arch Dis Child Fetal Neonatal Ed. 2001; 85(1):F42-5. PMC: 1721289. DOI: 10.1136/fn.85.1.f42. View

Mittnacht A . Near infrared spectroscopy in children at high risk of low perfusion. Curr Opin Anaesthesiol. 2010; 23(3):342-7. DOI: 10.1097/ACO.0b013e3283393936. View

Petrova A, Bhatt M, Mehta R . Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus. J Perinatol. 2011; 31(7):460-4. DOI: 10.1038/jp.2010.200. View

Crissinger K . Animal models of necrotizing enterocolitis. J Pediatr Gastroenterol Nutr. 1995; 20(1):17-22. View

Havranek T, Thompson Z, Carver J . Factors that influence mesenteric artery blood flow velocity in newborn preterm infants. J Perinatol. 2006; 26(8):493-7. DOI: 10.1038/sj.jp.7211551. View

Robel-Tillig E, Knupfer M, Pulzer F, Vogtmann C . Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants. Pediatr Radiol. 2004; 34(12):958-62. DOI: 10.1007/s00247-004-1285-6. View

Hackett G, Campbell S, GAMSU H, Pearce J . Doppler studies in the growth retarded fetus and prediction of neonatal necrotising enterocolitis, haemorrhage, and neonatal morbidity. Br Med J (Clin Res Ed). 1987; 294(6563):13-6. PMC: 1245037. DOI: 10.1136/bmj.294.6563.13. View

Murdoch E, Sinha A, Shanmugalingam S, Smith G, Kempley S . Doppler flow velocimetry in the superior mesenteric artery on the first day of life in preterm infants and the risk of neonatal necrotizing enterocolitis. Pediatrics. 2006; 118(5):1999-2003. DOI: 10.1542/peds.2006-0272. View

van Bel F, van Zwieten P, Guit G, Schipper J . Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates. Radiology. 1990; 174(1):165-9. DOI: 10.1148/radiology.174.1.2403678. View

10.

Lane A, Coombs R, Evans D, Levin R . Effect of feed interval and feed type on splanchnic haemodynamics. Arch Dis Child Fetal Neonatal Ed. 1998; 79(1):F49-53. PMC: 1720805. DOI: 10.1136/fn.79.1.f49. View

11.

Leidig E . Doppler analysis of superior mesenteric artery blood flow in preterm infants. Arch Dis Child. 1989; 64(4 Spec No):476-80. PMC: 1592043. DOI: 10.1136/adc.64.4_spec_no.476. View

12.

Papacci P, Giannantonio C, Cota F, Latella C, Semeraro C, Fioretti M . Neonatal colour Doppler ultrasound study: normal values of abdominal blood flow velocities in the neonate during the first month of life. Pediatr Radiol. 2009; 39(4):328-35. DOI: 10.1007/s00247-008-1112-6. View

13.

Martinussen M, Brubakk A, Vik T, Yao A . Mesenteric blood flow velocity and its relation to transitional circulatory adaptation in appropriate for gestational age preterm infants. Pediatr Res. 1996; 39(2):275-80. DOI: 10.1203/00006450-199602000-00015. View

14.

Meier S, Eble B, STAPLETON G, Morales D, Chang A, Andropoulos D . Mesenteric oxyhemoglobin desaturation improves with patent ductus arteriosus ligation. J Perinatol. 2006; 26(9):562-4. DOI: 10.1038/sj.jp.7211559. View

15.

McNeill S, Gatenby J, McElroy S, Engelhardt B . Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2010; 31(1):51-7. PMC: 3013378. DOI: 10.1038/jp.2010.71. View

16.

Cortez J, Gupta M, Amaram A, Pizzino J, Sawhney M, Sood B . Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates. J Matern Fetal Neonatal Med. 2010; 24(4):574-82. DOI: 10.3109/14767058.2010.511335. View