Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants

Robel-Tillig, E.; Knüpfer, M.; Pulzer, F.; Vogtmann, C

doi:10.1007/s00247-004-1285-6

Cited by 71 publications

(54 citation statements)

References 25 publications

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“…19,20 It is not clear if the attenuated SMA BFV was owing to CPAP-related decreases in cardiac output, nor if bowel-related concerns with CPAP relate to our finding of attenuated increases in postnatal SMA BFV in infants on CPAP. However, other investigators have reported that attenuated increases in postnatal SMA BFV are associated with intestinal dysmotility, 2 and with feeding intolerance. 3,4 Ongoing studies in our NICU are designed to further elucidate the relationship between CPAP, postnatal SMA BFV and clinical outcomes.…”

Section: Discussionmentioning

confidence: 93%

“…1 There is increasing evidence that the rate of increase in SMA BFV may have clinical significance. Greater increases in postnatal SMA BFV during the first week of life in preterm infants are reportedly associated with less intestinal dysmotility, 2 and with better tolerance to enteral feedings. 3,4 Intestinal blood flow is regulated by numerous factors including cardiovascular status, neural control, humoral substances and local control.…”

Section: Introductionmentioning

confidence: 97%

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Factors that influence mesenteric artery blood flow velocity in newborn preterm infants

2006

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Objectives: To identify demographic and clinical variables that relate to the postnatal increase in intestinal blood flow velocity in preterm infants.Study design: Fasting or preprandial peak systolic velocity (PSV) and time-averaged mean velocity (TAMV) in the superior mesenteric artery were measured once each day for the first 5 days of life. We investigated the relationship between blood flow velocity and the following variables: birth weight, gestational age, feeding volumes, number of days to reach full feeding volumes, type of feeding given, continuous positive airway pressure (CPAP) administration and hyperalimentation (HAL) administration.Results: Twenty-five infants with a mean birth weight of 1740 g and mean gestational age of 31.8 weeks were studied. There were significant increases in PSV (P<0.001) and TAMV (P ¼ 0.005) from postnatal day 1 to 5. The postnatal increase in TAMV and PSV was attenuated in infants administered CPAP or HAL for X3 days; the results remained significant after controlling for birth weight and gestational age. There was a significant correlation (P<0.02) between volume of enteral feedings given on 2 of 5 days for TAMV, and on 1 of 5 days for PSV.Conclusions: These data support previous findings of significant increases in intestinal blood flow in preterm infants during the first week of life, and of inconsistent effects of enteral feeding volumes on fasting or preprandial intestinal blood flow. The reasons for, and the clinical implications of, attenuated increases in postnatal intestinal blood flow in infants on CPAP or HAL require further investigation.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 97%

Factors that influence mesenteric artery blood flow velocity in newborn preterm infants

2006

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“…4 We previously reported that CPAP administration was associated with an attenuation of the postnatal increase in superior mesenteric artery blood flow velocity (SMA BFV) in preterm infants. 5 Attenuated increases in postnatal SMA BFV are reportedly associated with intestinal dysmotility 6 and with feeding intolerance. 7 Our objective was to further investigate the effect of CPAP on intestinal blood flow velocity by measuring pre-and postprandial SMA BFV in preterm infants when they were receiving CPAP ('on CPAP') and after CPAP was discontinued ('off CPAP').…”

Section: Introductionmentioning

confidence: 99%

Nasal continuous positive airway pressure affects pre- and postprandial intestinal blood flow velocity in preterm infants

2007

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Objective: To measure the effect of nasal continuous positive airway pressure (CPAP) on intestinal blood flow velocity responses to enteral feedings and left ventricular output (LVO).Study Design: Eighteen infants completed the study (birth weight 1793±350 g, gestational age 32.1±1.1 weeks). On the day infants were weaned from CPAP to room air, pre-and postprandial (0, 30, 60 and 90 min after feeding) mean velocity (MV), peak systolic velocity (PSV) and end diastolic velocity (EDV) were measured for one feeding given when receiving CPAP ('on CPAP'), and for one feeding given after CPAP had been discontinued ('off CPAP'). Preprandial LVO was measured before and after CPAP discontinuation.Result: MV and PSV were significantly lower when infants were on CPAP (P<0.05). Maximum postprandial MV, PSV and EDV occurred at 30 min when on CPAP and at 60 min when off CPAP. Preprandial LVO was similar when infants were on and off CPAP. Keywords: nutrition; neonate; Doppler ultrasound; CPAP belly syndrome; respiratory distress syndrome; cardiac output Introduction Nasal continuous positive airway pressure (CPAP) is used increasingly for the treatment of respiratory distress in premature neonates. Compared with intubation or mechanical ventilation, CPAP is associated with decreased incidence of bronchopulmonary dysplasia and sepsis, and with a trend toward decreased incidence of retinopathy of prematurity and intraventricular hemorrhage.

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“…Blood flow velocity in the superior mesenteric artery, measured using Doppler ultrasound in 478 very-low-birth-weight neonates (<1500 g), was predictive of subsequent intestinal dysmotility and correlated with the quantity of tolerated enteral feeding. 12 In this case, the pulsatility index showed 95% sensitivity and 82% specificity in predicting intestinal dysmotility. Color Doppler U/S may be useful in determining bowel viability, which can be characterized by bowel wall thickness and perfusion.…”

Section: Ultrasonographymentioning

confidence: 67%

Monitoring technologies in the neonatal intensive care unit: implications for the detection of necrotizing enterocolitis

Young

Gravenstein

et al. 2010

J Perinatol

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Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants

Abstract: Pathological blood flow parameters in the SMA can predict problems of intestinal motility and tolerance of enteral feeding. With the early detection of these problems a prompt start of adequate therapy to avoid complications is possible.

Cited by 71 publications

References 25 publications

Factors that influence mesenteric artery blood flow velocity in newborn preterm infants

Factors that influence mesenteric artery blood flow velocity in newborn preterm infants

Nasal continuous positive airway pressure affects pre- and postprandial intestinal blood flow velocity in preterm infants

Monitoring technologies in the neonatal intensive care unit: implications for the detection of necrotizing enterocolitis

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