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Published on: December 31, 2015
Factors that influence mesenteric artery blood flow velocity in newborn preterm infants
T Havranek1, Z Thompson, J D Carver
1Department of Pediatrics, Division of Neonatology, University of South Florida College of Medicine, USF Pediatrics, Tampa, FL 33606, USA. thavrane@hsc.usf.edu
Insights
Intestinal blood flow velocity increases in preterm infants during their first week. Continuous positive airway pressure (CPAP) or hyperalimentation (HAL) may attenuate this increase, requiring further study.
Area of Science:
- Neonatal physiology
- Pediatric gastroenterology
Background:
- Intestinal blood flow is crucial for preterm infant development.
- Understanding factors influencing intestinal blood flow is vital for neonatal care.
Purpose of the Study:
- To identify demographic and clinical factors associated with increased intestinal blood flow velocity in preterm infants during the first week of life.
Main Methods:
- Measured peak systolic velocity (PSV) and time-averaged mean velocity (TAMV) in the superior mesenteric artery daily for the first 5 days.
- Correlated blood flow velocities with birth weight, gestational age, feeding volumes, and interventions like CPAP and hyperalimentation (HAL).
Main Results:
- Significant increases in PSV and TAMV were observed from postnatal day 1 to 5.
- The increase in TAMV and PSV was attenuated in infants receiving CPAP or HAL for ≥3 days.
- Enteral feeding volumes showed a significant correlation with TAMV and PSV on specific days.
Conclusions:
- Confirms increased intestinal blood flow in preterm infants during the first week.
- Suggests CPAP or HAL may attenuate this increase, warranting further investigation into clinical implications.
- Enteral feeding volume effects on fasting intestinal blood flow are inconsistent.
Objectives:
To identify demographic and clinical variables that relate to the postnatal increase in intestinal blood flow velocity in preterm infants.
Study Design:
Fasting or preprandial peak systolic velocity (PSV) and time-averaged mean velocity (TAMV) in the superior mesenteric artery were measured once each day for the first 5 days of life. We investigated the relationship between blood flow velocity and the following variables: birth weight, gestational age, feeding volumes, number of days to reach full feeding volumes, type of feeding given, continuous positive airway pressure (CPAP) administration and hyperalimentation (HAL) administration.
Results:
Twenty-five infants with a mean birth weight of 1740 g and mean gestational age of 31.8 weeks were studied. There were significant increases in PSV (P < 0.001) and TAMV (P = 0.005) from postnatal day 1 to 5. The postnatal increase in TAMV and PSV was attenuated in infants administered CPAP or HAL for > or =3 days; the results remained significant after controlling for birth weight and gestational age. There was a significant correlation (P < 0.02) between volume of enteral feedings given on 2 of 5 days for TAMV, and on 1 of 5 days for PSV.
Conclusions:
These data support previous findings of significant increases in intestinal blood flow in preterm infants during the first week of life, and of inconsistent effects of enteral feeding volumes on fasting or preprandial intestinal blood flow. The reasons for, and the clinical implications of, attenuated increases in postnatal intestinal blood flow in infants on CPAP or HAL require further investigation.
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