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Splanchnic haemodynamic disturbances in perinatal sepsis
1Neonatal Unit, Royal London Hospital, Whitechapel, St Bartholomew's and the Royal London School of Medicine and Dentistry, London, UK.
Aim:
To determine the effect of perinatal bacterial infection on the neonatal splanchnic circulation.
Subjects/Setting:
76 premature infants with appropriate birth weight for gestation admitted for neonatal intensive care.
Methods:
Doppler ultrasound was used to measure blood flow velocity and pulsatility index in the superior mesenteric artery and coeliac axis during the first 24 hours of life. Babies were classified according to the results of blood and surface cultures, as well as the presence or absence of maternal prolonged membrane rupture.
Results:
Infection status had a significant effect on pulsatility index in both arteries, with that in the coeliac axis being reduced from 1.27 to 0.80 in babies with infection (p < 0.0001). Coeliac axis blood flow velocity was significantly increased in those with infection (from 34.6 to 46.5 cm/s; p < 0.05).
Conclusion:
As early as the first day of postnatal life, infected neonates show a pattern of splanchnic hyperaemia similar to that found in adult systemic inflammatory response syndrome.