Very early postnatal changes in splanchnic circulation in term infants

Paulusova, E; Matasová, Katarína; Zibolenová, Jana; Lucanova, Lucia Casnocha; Kocvarova, Lenka; Zibolen, Mirko

doi:10.1007/s00247-013-2825-8

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…The intestinal blood supply is also considered one of the major risk factors for NEC. The SMA has less blood flow prenatally, which is manifested as high‐resistance blood flow, and it increases rapidly because of the change in the fetal circulation and the stimulation of feeding after birth . Unlike full‐term neonates, changes in SMA blood flow occur later in the early postnatal period of preterm neonates.…”

Section: Discussionmentioning

confidence: 99%

“…The SMA has less blood flow prenatally, which is manifested as high-resistance blood flow, and it increases rapidly because of the change in the fetal circulation and the stimulation of feeding after birth. [20][21][22] Unlike full-term neonates, changes in SMA blood flow occur later in the early postnatal period of preterm neonates. Moreover, SMA blood flow is less responsive to physiologic processes such as feeding than full-term neonates.…”

Section: Discussionmentioning

confidence: 99%

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Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Yue

Deng

Yang

et al. 2019

J of Ultrasound Medicine

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Objectives-The purpose of this study was to reveal the correlation between superior mesenteric artery (SMA) blood flow in the first 12 hours of life and the risk of necrotizing enterocolitis (NEC) in preterm neonates.Methods-We conducted a prospective study. There were 104 preterm neonates included in our study. The SMA blood flow of each neonate was measured during the first 12 hours of life if the hemodynamic situation was stable. The results of Doppler ultrasound were confidential to the neonatologists and nurses. All of the demographics, comorbidities, and outcomes were recorded and analyzed.Results-Among all of the demographics and comorbidities, the gestational age was related to the measurements of SMA blood flow. We conducted a singlefactor analysis of the occurrence of NEC, including the peak systolic velocity (PSV), end-diastolic velocity, time-averaged mean velocity, differential velocity (DV), resistive index, and pulsatility index. A higher PSV (median [interquartile range], 54.165 [42.423-68.463] versus 42.195 [34.278-48.553] cm/s; P = .027) and DV (median [interquartile range], 47.445 [35.010-60.043] versus 32. 565 [27.545-39.073] cm/s; P = .020) were significantly related to the risk of NEC. In the logistic analysis including gestational age, PSV, and DV, NEC was significantly associated with gestational age (odds ratio [95% confidence interval], 0.644 [0.456-0.908]; P = .012) and DV (odds ratio [95% confidence interval], 1.144 [1.058-1.237]; P < .01). The area under the receiver operating characteristic curve for the DV was 0.768, with sensitivity 0.875 and specificity 0.604. The cutoff value of the DV was 34.835 cm/s. Conclusions-From this single-center study, we can see the promising value of Doppler ultrasound for the prediction of NEC, but further research is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Yue

Deng

Yang

et al. 2019

J of Ultrasound Medicine

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“…The superior mesenteric artery (SMA) is one of the three major visceral arteries arising from the abdominal aorta and is the main blood supply to the small intestine and a portion of the large intestine [5]. Although prenatal SMA blood flow is diminished, manifesting as high resistance, it increases rapidly after birth because of the change in fetal circulation [5][6][7]. Doppler ultrasound may be a valuable tool in monitoring disease progression as it enables the detection of changes in intestinal perfusion before severe damage to the intestinal epithelium occurs [8,9].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of the role of Doppler ultrasonography of the superior mesenteric artery in detecting neonates at risk of necrotizing enterocolitis

et al. 2023

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The role of postnatal Doppler measurements of the superior mesenteric artery (SMA) in detecting neonates at risk of necrotizing enterocolitis (NEC) remains uncertain; therefore, we systematically reviewed and meta-analyzed the existing evidence regarding the usefulness of SMA Doppler measurements in detecting neonates at risk for NEC. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, and we included studies which reported the following Doppler ultrasonography indices: peak systolic velocity, end-diastolic velocity, time average mean velocity, differential velocity, pulsatility index (PI) and resistive index. Eight studies were eligible for inclusion in the meta-analysis. Evidence suggested that, during the first postnatal day, neonates who developed NEC had a significantly higher peak systolic velocity (mean difference of 2.65 cm/s (95% confidence interval [CI] 1.23, 4.06, overall effect Z=3.66, P<0.001)), higher PI (mean difference of 1.52 (95% CI 0.00, 3.04, Z=1.96, P=0.05)) and higher resistive index (mean difference of 1.09 (95% CI 0.59, 1.60, Z=4.24, P<0.001)), compared to neonates who did not develop NEC. However, our findings do not support a strong association between the Doppler ultrasound indices and development of NEC at the time of disease onset. This meta-analysis suggests that first postnatal day SMA Doppler parameters, namely peak systolic velocity, PI and resistive index, are higher in neonates who develop NEC. On the other hand, the aforementioned indices are of uncertain significance once the diagnosis of NEC has been established. Graphical abstract

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Normative and pathological values of hemodynamic and Doppler ultrasound arterial findings in children

Trihan¹,

Pérez‐Martin

Guillaumat

et al. 2020

Vasa

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Summary. Doppler ultrasound is an effective, useful and remarkably powerful tool in pediatric imaging. If possible, its use is always favored to avoid exposure to radiation or sedatives. By waveform spectrum analysis, Doppler ultrasound reveals information on blood flow and details on normal physiology and pathological processes undiscernible from gray-scale imaging alone. However, Doppler ultrasound remains underused, largely due to the difficult interpretation of changes in Doppler waveforms during childhood. This article provides a narrative review of the literature regarding the normative values and the physiological arterial changes through childhood according to age, weight or height, as well as frequent pathological arterial findings in children, classified by arterial territory.

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Very early postnatal changes in splanchnic circulation in term infants

Abstract: Important changes occur in splanchnic circulation during the first 6 h after birth. The rise in end-diastolic velocity in the superior mesenteric artery from negative to positive values in 83% of healthy term newborns is the most important change.

Cited by 5 publications

References 11 publications

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

A systematic review and meta-analysis of the role of Doppler ultrasonography of the superior mesenteric artery in detecting neonates at risk of necrotizing enterocolitis

Normative and pathological values of hemodynamic and Doppler ultrasound arterial findings in children

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