Gastrointestinal and renal blood flow velocity profile in neonates with birth asphyxia,☆☆,

https://doi.org/10.1016/S0022-3476(94)70024-9Get rights and content

Abstract

Pulsed Doppler ultrasound blood flow profiles were studied, before the initiation of enteral feedings, in 23 neonates with birth asphyxia. We observed a significant direct correlation between the reduction of peak velocity and increased resistance in the renal and superior mesenteric arteries to the severity of asphyxia (r =0.8; p < 0.05); the changes often persisted up to 3 days of age. Longitudinal evaluation of flow in these vessels might help to time the initiation of enteral nutrition in neonates with asphyxia. (J PEDIATR 1994;125:625-7)

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

References (11)

  • RM Kliegman et al.

    Epidemiologic study of NEC among low birthweight infants

    J PEDIATR

    (1982)
  • PT Nowicki et al.

    Gastrointestinal blood flow and oxygen consumption in newborn lambs: effect of chronic anemia and acute hypoxia

    Pediatr Res

    (1984)
  • E. Leidig

    Doppler analysis of superior mesenteric artery blood flow in preterm infants

    Arch Dis Child

    (1989)
  • F Van Bel et al.

    Effect of indocin on superior mesenteric artery blood flow velocity in preterm babies

    J PEDIATR

    (1990)
  • MO Visser et al.

    Renal blood flow in neonates: quantification with color flow and pulsed Doppler ultrasound

    Radiology

    (1992)
There are more references available in the full text version of this article.

Cited by (48)

View all citing articles on Scopus

From the Section of Newborn Pediatrics and Department of Radiology, Pennsylvania Hospital, and the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia

☆☆

Reprint requests: Soraya Abbasi, MD, Section on Newborn Pediatrics, Pennsylvania Hospital, 800 Spruce St., Philadelphia, PA 19107.

0022-3476/94/$3.00 + 0 9/24/57497

View full text