Doppler ultrasound assessment of splanchnic perfusion and heart rate for the detection of necrotizing enterocolitis.

Abstract

PURPOSE:

Monitoring disease progression is crucial to improve the outcome of necrotizing enterocolitis (NEC). A previous study indicates that intestinal wall flow velocity was reduced in NEC pups from the initial stages of the disease. This study aims to investigate whether splanchnic perfusion via the superior mesenteric artery (SMA) (i) is altered during NEC development and (ii) can be used as a monitoring tool to assess disease progression.

METHODS:

NEC was induced in C57BL/6 mice via gavage feeding of formula, hypoxia, and oral lipopolysaccharide, from postnatal day 5 (P5) to P9 (AUP: 32,238). Breastfed littermates served as controls. Doppler ultrasound (U/S) of bowel loops was performed daily. Intestinal wall perfusion was calculated as average flow velocity (mm/s) of multiple abdominal regions. Groups were compared using one-way ANOVA.

RESULTS:

The SMA flow velocity was not altered during the initial stage of NEC development, but become significantly reduced at P8 when the intestinal disease was more advanced. These changes occurred concomitantly with an increase in heart rate.

CONCLUSIONS:

NEC is associated with intestinal hypo-perfusion at the periphery and flow in the SMA is reduced during the later stages of disease indicating the presence of intestinal epithelium damage. This study contributes to understanding NEC pathophysiology and illustrates the value of Doppler U/S in monitoring disease progression.

• Authors: Niloofar Ganji, Yuhki Koike, Bo Li, Haitao Zhu, Ethan Lau, Maarten Janssen Lok, Carol Lee, Agostino Pierro
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 37 Issue 3 Pg. 347-352 (Mar 2021) ISSN: 1437-9813 [Electronic] Germany
• PMID: 33580271 (Publication Type: Journal Article)

Topics

• Animals
• Disease Models, Animal
• Enterocolitis, Necrotizing (physiopathology)
• Heart Rate
• Humans
• Infant, Newborn
• Infant, Newborn, Diseases
• Intestinal Mucosa (physiopathology)
• Intestines (physiopathology)
• Male
• Mesenteric Artery, Superior (diagnostic imaging, physiology)
• Mice
• Mice, Inbred C57BL
• Perfusion
• Ultrasonography, Doppler