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Year : 2018  |  Volume : 7  |  Issue : 4  |  Page : 243-249

Splanchnic hemodynamics as a predictor of feeding tolerance in preterm neonates

1 Department of Pediatric, Clinical Nutrition Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 NICU Unit, Obstetric and Gynecology Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Dr. Marwa Hosni Abdel Hamed
Department of Paediatric, Faculty of Medicine, Ain Shams University, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.JCN_53_18

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Background: The superior mesenteric artery (SMA) supplies the greatest volume of blood to the small intestine. The use of Doppler ultrasound to measure SMA blood flow velocity (BFV) is increasingly used to investigate intestinal hemodynamics in neonates. Aim: The aim of this study was designed to correlate Doppler indices of splanchnic perfusion and vascular resistance to early tolerance of feeding and development of necrotizing enterocolitis in preterm (PT) infants. Setting and Design: This study was conducted at the Neonatal Intensive Care Unit, Ain Shams University Hospital, Cairo Governorate, Egypt. Subjects and Methods: Complete Prenatal, natal, and postnatal history were taken; blood culture and complete blood count, C-reactive protein with titer, and assessment of BFA in SMA at day (D) 1 and D7 of life, including peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI), were done upon enrollment of 65 neonates who subdivided into either PT groups, hypoxic-ischemic encephalopathy group, or full-term group. Results: There was a significant difference between the three groups regarding PSV, EDV, and RI before and after feeding. As for the qualitative data of the Doppler indices of SMA, there was a statistically significant difference between the three groups as regards the PI in D1 (P = 0.022), PSV in D7 (P = 0.018), and EDV in D7 (P = 0.040); however, there was no significant difference between the three groups as regard PSV in D1, EDV in D1, RI in D1 and D7, and PI in D7. Conclusion: Doppler hemodynamic studies of SMA in PT infants showed that change in RI parameter in response to small enteral feeds proved to have a highly significant difference with the dependent variable (feeding tolerance) which might be a good tool for the clinician in predicting early tolerance to enteral feeding.

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