Doppler Analysis of Postprandial Intestinal Blood Flow in Healthy Preterm Infants |
Yu In Park, Young Kook Kim, Young Sook Hong |
Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea |
건강 미숙아에서 경구영양후의 장혈류변화에 관한 연구 |
박유인, 김영국, 홍영숙 |
고려대학교 의과대학 소아과학교실 |
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Abstract |
Purpose : The newborn period is a time of rapid physiological change in the gastrointestinal tract, when adaptation from a state of parenteral nutrition to the demands of enteral feeding take place. little is known about the intestinal vascular responses that accompany intestinal adaptive changes, although there is much speculation about the relationship between entreral feeding, alterations in gut perfusion, and the development of necrotizing enterocolitis. Doppler ultrasound can be readily used to measure intestinal blood flow velocities in human newborn. It provides a noninvasive technique for investigating adaptive postnatal changes in the intestinal circulation, and, in particular, the response to feeds. In this study, we have measured blood flow indices in both the superior mesenteric artery and ceLiac axis, Looking for postprandial changes in response to feeding in 16 healthy preterm infants.
Methods : By using the Doppler ultrasound, PSV(peak systolic blood flow velocity),
EDV(end diastolic blood flow velocity), Pulsatility index and blood flow per minute were measured pre and postprandially on day 1,3, and 5 oflife. Since the postprandial
changes were similar during the study periods, the pre- and postfeed values are
presented as combined resuLts.
Results : 1) The PSV and EDV from the superior mesenteric artery before the feed were
65.12¡¾11.16cm/secand 15.40¡¾3.58cm/sec, respectively, and rose to 74.55¡¾13.11cm/sec
and 19.10¡¾4.81cm/sec(p<0.001)(p<0.001). The pulsatility index fell from 0.761¡¾0.053 to 0.735¡¾0.055(p<0.05) and blood flow per minute was increased from 0.110¡¾0.032 l/min to 0.123¡¾0.027l/min(p<0.05).
2) Similar results were obtained from the celiac axis: The PSV and EDV increased
from 68.23¡¾16.29 cm/sec, 16.54¡¾5.77 cm/sec to 77.92¡¾15.08 cm/sec, 21.14¡¾6.95 cm/sec, respectively(p<0.05)(p<0.001). The pulsatility index fell from 0.760¡¾0.068 to 0.722¡¾0.077(p<0.001) and blood flow per minute was increased from 0.126¡¾0.029 l/min to 0.153¡¾0.033l/min, posprandially(p<0.001).
3) The magnitude of increment in velocity was independent of gestational age, sex,
and initial body weignt.
Conclusion : We have measured intestinal blood flow indices in response to feeding
by Doppler ultrasound and Doppler ultrasound may be able to provide evidence
regarding disturbed perfusion as a potential etiological agentin the pathogenesis of
necrotizing enterocolitis. |
Key Words:
Doppler ultrasound, Blood flow velocity, Intestine, Preterm infants |
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