Intestinal hydrogen and nitric oxide gases in preterm infants--effects of antibiotic therapy

Measurements of hydrogen (H(2)) and nitric oxide (NO) levels in intestinal gas have recently been shown to be useful to monitor bacterial colonization in healthy term newborn infants. The significance of preterm birth and antibiotic therapy for intestinal gas production is not known and was the subject of this study.

A minimally invasive tonometric technique was used for repeated measurements (44 samples) of luminal colonic H(2) and NO in 23 preterm infants with gestational age 27-35 weeks, birth weight 1,170-2,996 g and postnatal age 2-31 days.

The measuring procedure was well tolerated in all infants. Intestinal H(2) was 300 (4-1,990) ppm and NO was 34 (11-82) ppb. Intestinal H(2) and NO increased during the first week (p < 0.05) to average levels that in the case of H(2), exceeded those of healthy, term infants. In preterm infants treated with antibiotics (n = 12), H(2) and NO levels were significantly lower than in those without such therapy (p < 0.05).

These observations suggest that intestinal measurements of H(2) and NO may be used to monitor birth-related bacterial colonization in relation to postnatal age, maturation and antibiotic therapy. In preterm infants, gaseous distension of the gut is common and may signal bacterial overgrowth. The potential role of intestinal gas measurements as a diagnostic tool for intestinal disorders remains to be clarified.