Doppler ultrasound assessment of splanchnic perfusion and heart rate for the detection of necrotizing enterocolitis
- 12 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Pediatric Surgery International
- Vol. 37 (3), 347-352
- https://doi.org/10.1007/s00383-020-04819-5
Abstract
Purpose Monitoring disease progression is crucial to improve the outcome of necrotizing enterocolitis (NEC). A previous study indicates that intestinal wall flow velocity was reduced in NEC pups from the initial stages of the disease. This study aims to investigate whether splanchnic perfusion via the superior mesenteric artery (SMA) (i) is altered during NEC development and (ii) can be used as a monitoring tool to assess disease progression. Methods NEC was induced in C57BL/6 mice via gavage feeding of formula, hypoxia, and oral lipopolysaccharide, from postnatal day 5 (P5) to P9 (AUP: 32,238). Breastfed littermates served as controls. Doppler ultrasound (U/S) of bowel loops was performed daily. Intestinal wall perfusion was calculated as average flow velocity (mm/s) of multiple abdominal regions. Groups were compared using one-way ANOVA. Results The SMA flow velocity was not altered during the initial stage of NEC development, but become significantly reduced at P8 when the intestinal disease was more advanced. These changes occurred concomitantly with an increase in heart rate. Conclusions NEC is associated with intestinal hypo-perfusion at the periphery and flow in the SMA is reduced during the later stages of disease indicating the presence of intestinal epithelium damage. This study contributes to understanding NEC pathophysiology and illustrates the value of Doppler U/S in monitoring disease progression.Keywords
This publication has 48 references indexed in Scilit:
- Intestinal Blood Flow by Doppler Ultrasound: The Impact of Gestational Age and Time from First Enteral Feeding in Preterm NeonatesAmerican Journal of Perinatology, 2013
- Probiotics and Necrotizing Enterocolitis: Finding the Missing Pieces of the Probiotic PuzzleThe Journal of Pediatric Pharmacology and Therapeutics, 2012
- Branched Chain Fatty Acids Reduce the Incidence of Necrotizing Enterocolitis and Alter Gastrointestinal Microbial Ecology in a Neonatal Rat ModelPLOS ONE, 2011
- Altered intestinal microcirculation is the critical event in the development of necrotizing enterocolitisJournal of Pediatric Surgery, 2011
- Association of necrotizing enterocolitis with anemia and packed red blood cell transfusions in preterm infantsJournal of Perinatology, 2011
- Inter-Alpha Inhibitor Protein Level in Neonates Predicts Necrotizing EnterocolitisThe Journal of Pediatrics, 2010
- Epidemiology of necrotizing enterocolitis – Part II: Risks and susceptibility of premature infants during the surfactant era: A regional studyJournal of Paediatrics and Child Health, 2005
- Doppler sonographic detection of increased flow velocities in the celiac trunk and superior mesenteric artery in infants with necrotizing enterocolitisPediatric Radiology, 1993
- Abnormal Gut Blood Flow Velocities in Neonates at Risk of Necrotising EnterocolitisJournal of Pediatric Gastroenterology and Nutrition, 1992
- Pathology of neonatal necrotizing enterocolitis: A ten-year experienceThe Journal of Pediatrics, 1990