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Doppler assessment of human neonatal gut blood flow velocities: postnatal adaptation and response to feeds
R C Coombs1, M E Morgan, G M Durbin
1Institute of Child Health, University of Birmingham, U.K.
Insights
Newborn gut blood flow increases post-birth, with higher velocities in bottle-fed infants after feeding. Doppler ultrasound noninvasively measures these adaptive changes in the splanchnic circulation.
Area of Science:
- Neonatal Physiology
- Vascular Ultrasound
- Pediatric Gastroenterology
Background:
- Gut blood flow is critical for neonatal adaptation.
- Understanding postnatal circulatory changes is essential for infant health.
- Noninvasive methods are needed to assess splanchnic circulation in newborns.
Purpose of the Study:
- To investigate changes in gut blood flow velocities during the first week of life in term infants.
- To compare blood flow responses to feeding in breast-fed versus bottle-fed neonates.
- To evaluate the utility of Doppler ultrasound in assessing neonatal splanchnic circulation.
Main Methods:
- Duplex pulsed Doppler ultrasound was employed.
- Measurements were taken in the superior mesenteric artery and coeliac axis.
- 14 term infants were studied during their first week of life.
Main Results:
- Fasting peak systolic velocity in the superior mesenteric artery significantly increased from day 1 to day 5.
- Post-feed velocities were higher in bottle-fed infants compared to breast-fed infants.
- Peak velocities occurred approximately 50 minutes after feeding in both groups.
Conclusions:
- Doppler ultrasound is a feasible noninvasive technique for measuring neonatal gut blood flow.
- The study demonstrates adaptive postnatal changes in splanchnic circulation.
- Feeding method influences the gut blood flow response in newborns.
Abstract:
Duplex pulsed Doppler ultrasound was used to study changes in gut blood flow velocities during the first week of life in a group of 14 term babies. There was a significant increase in fasting peak systolic velocity in the superior mesenteric artery between days 1 and 2 with a further upward trend until day 5; no such changes were seen in the coeliac axis. Fasting velocities were 20% lower in breast-fed babies than bottle-fed babies. Following feeds, there was a significant increase in velocity in the superior mesenteric artery that was 35% greater in the bottle-fed than breast-fed babies. Changes in the coeliac axis were qualitatively similar but substantially smaller. The peak velocity in both vessels occurred 50 min after a feed. We conclude that Doppler ultrasound can be readily used to measure gut blood flow velocities in the human newborn. It provides a noninvasive technique for investigating adaptive postnatal changes in the splanchnic circulation, and, in particular, the response to feeds.