Gastrointestinal and renal blood flow velocity profile in neonates with birth asphyxia☆,☆☆,★
Section snippets
METHODS
Twenty-three term neonates with cord blood pH <7.20, a 5-minute Apgar score <7, or both were enrolled in this study if they were otherwise in clinically stable condition. None of the neonates was being supported by mechanical ventilation or receiving cardioactive medications. All subjects were studied within 24 hours of birth. Patients were excluded because of prematurity, congenital anomalies, or prenatal exposure to medications that might be responsible for birth asphyxia. Informed consent
RESULTS
At the time of the study, the babies were in clinically stable condition. Mean birth weight and gestational age (ISD) were 3.1 ± 0.6 kg and 38.0 ± 1.6 weeks, respectively. The mean cord pH was 7.01 (range, 6.8 to 7.3), and the median Apgar score was 5 (range, 4 to 8). Five infants were studied within 6 hours of life and 17 within 24 hours. Six babies had grossly abnormal flow profiles in the SMA with either no or retrograde diastolic flows. These babies were restudied every 24 hours until the
DISCUSSION
Autoregulation of regional circulation varies from organ to organ in the term neonate. Asphyxia may lead to significant regional hemodynamic disturbances. The gastrointestinal tract and the kidneys are believed to be particularly vulnerable to hemodynamic perturbation as a result of perinatal hypoxemia. This could result in bowel ischemia as an antecedent of necrotizing enterocolitis.1, 6 Thus feedings are often withheld for a variable and arbitrary length of time in an attempt to avert
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2022, Developmental Neuroscience
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From the Section of Newborn Pediatrics and Department of Radiology, Pennsylvania Hospital, and the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia
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Reprint requests: Soraya Abbasi, MD, Section on Newborn Pediatrics, Pennsylvania Hospital, 800 Spruce St., Philadelphia, PA 19107.
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0022-3476/94/$3.00 + 0 9/24/57497