Gastrointestinal emergencies and monitoring in preterm infants: a review

Gastrointestinal emergencies are some of the severe complications in preterm infants, often resulting in fatal patient outcomes due to unintended delays in making precise diagnoses and initiating timely treatment. These delays arise from the non-specificity of observed gastrointestinal events, as well as the shortcomings of the existing monitoring methods used clinically. Therefore, effectively gastrointestinal monitoring should be emphasized to facilitate early detection and prevention of gastrointestinal diseases in preterm infants.

We collected relevant studies by searching literature published on PubMed, Embase, Cochrane Library, and Google Scholar up to December 2024.

We found that various non-traditional tools have been developed, including automated bowel sound, near-infrared spectroscopy, electrogastrography, intra-abdominal pressure monitoring, fecal microbiome monitoring, fecal biomarkers monitoring, high-frequency heart rate variability. These monitoring methods may provide clues for the early warning of gastrointestinal emergencies, and future research focused on early warnings to improve prognosis of preterm infants is worth conducting.

This review discusses common gastrointestinal events in preterm infants, the current state of gastrointestinal emergencies (necrotizing enterocolitis, digestive tract obstruction or narrowing, and gastrointestinal bleeding), and focuses on the progress and prospects of gastrointestinal monitoring in preterm infants. It could potentially make a positive contribution to preterm infants outcomes and quality of life, particularly in addressing areas where current literature still lacks consensus or detailed analysis.