Feeding Tolerance, Intestinal Motility, and Superior Mesenteric Artery Blood Flow in Infants with Gastroschisis

Abstract

<b><i>Objective:</i></b><i></i>The aim of this study was to determine the relationship of superior mesenteric artery (SMA) blood flow and intestinal motility with feeding tolerance in infants with gastroschisis. <b><i>Study Design:</i></b> This was a prospective observational cohort study of 23 infants with gastroschisis. Magnetic resonance images were obtained at abdominal wall closure, initiation of feeds, and full feeds. Motility and SMA flow data were correlated with feeding tolerance. <b><i>Result:</i></b><i></i>All infants had abnormal motility, and most continued with abnormal motility despite achieving full feeds. Increased SMA flow at the time of abdominal wall closure was found to be significantly related to the earlier achievement of full feeds (ρ = –0.45, <i>p</i> = 0.05) and trended towards earlier initiation of feeds (ρ = –0.36, <i>p</i> = 0.13), shorter parenteral nutrition days (ρ = –0.42, <i>p</i> = 0.07), and earlier discharge (ρ = –0.41, <i>p</i> = 0.08). <b><i>Conclusion:</i></b> Increased SMA blood flow at the time of abdominal wall closure is positively correlated with feeding tolerance, suggesting the importance of initial intestinal perfusion in the pathophysiology for feeding intolerance and intestinal dysmotility in gastroschisis.

What is the main factor in predicting the morbidity and mortality in patients with gastroschisis: delivery time, delivery mode, closure method, or the type of gastroschisis (simple or complex)?

“…After surgical intervention, patients frequently suffer delayed bowel dysfunction due to intestinal dysmotility. TPN and gastric decompression should be provided during the abnormal intestinal motility period until enteral feeding is initiated [21]. Our time to initiate feeding, time to full enteral feeding, duration of TPN were similar to other recent studies [14,20,22].…”

Gastroschisis: Anatomic Defects, Etiopathogenesis, Treatment, and Prognosis

“…In a large, single-center cohort study of 97 neonates with gastroschisis, sutureless repair was associated with significant reduction in duration of mechanical ventilation and pain medication requirements, but with an increased risk of umbilical hernias, compared to sutured closure. 89 In low-income countries or places where preformed springloaded silo bags are not available, various kinds of sterile bags have been used instead including saline or a blood bag (Fig. 5) which require suturing of edge of bag to fascia under anesthesia.…”

Application Effect of Acupoint Massage on Zusanli on Premature Infants with Feeding Intolerance and Their Clinical Symptoms

“…Besides, in some cases, mental retardation also affects premature infants, further increasing the probability of death. erefore, the academic community should pay more attention to further exploring the clinical symptoms of premature infants with FI to provide solid theoretical support for the selection of suitable treatment and drugs [4][5][6][7]. At present, erythromycin is the main drug for the treatment of FI in clinical practice, whose mechanism is to enhance gastrointestinal motility and subsequently relieve the symptoms of FI in affected infants; however, this drug can also increase the incidence of abdominal pain and abdominal distension, so combination therapy should be implemented to improve treatment effect of FI.…”