Abstract
Objectives
To evaluate intestinal blood flow changes after intravenous immunoglobulin (IVIg) infusion among neonates with Rh isoimmunization and alloimmune thrombocytopenia.
Methods
This prospective observational study was conducted in level III NICU from July 2011 through August 2012. Thirty three consecutive instances (30 neonates) of IVIg treatment (1 g/kg) were studied. Celiac (CA) and superior mesenteric artery (SMA) doppler evaluations were performed immediately prior (baseline), immediately after and 12 to18 h following IVIg infusion. Peak systolic velocity, end diastolic velocity, time-averaged mean velocity, pulsatility index, resistive index and systolic/diastolic ratio were measured. The doppler indices measured immediately after and 12 to 18 h after IVIg infusion were compared with the baseline values.
Results
The mean gestation and birth weight of the cohort were 36 ± 2 wk and 2597 ± 563 g respectively. Doppler flow variables measured immediately after and 12 to 18 h after IVIg were comparable to baseline values, in both the arteries. However, systolic/diastolic ratio in SMA immediately post-IVIg was lower than baseline, [median (IQR): 5 (3, 9) vs. 7 (4, 14), respectively; p=0.02]. None of the study infants developed feed intolerance or necrotizing enterocolitis (NEC).
Conclusions
There was no significant change in the celiac and SMA blood flows following IVIg therapy in neonates with Rh isoimmunization and alloimmune thrombocytopenia.
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Contributions
DL wrote the protocol, enrolled neonates, performed doppler measurements and drafted the first manuscript. DL did not receive any grant, honorarium or any form of payment for writing the manuscript. SP helped in patient enrolment, data collection and reviewed the manuscript. SSS helped with study design, did statistical analysis and reviewed the manuscript. PK supervised the overall study, helped in data analysis, and critically reviewed the manuscript. SSS will act as guarantor for this paper.
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This study is registered with the Clinical Trial Registry of India (CTRI/2011/08/001955 dated 18/08/2011).
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Louis, D., Patil, S., Saini, S.S. et al. A Doppler Velocimetry Evaluation of Intestinal Blood Flow Characteristics in Neonates Receiving Intravenous Immunoglobulin Therapy: A Prospective Observational Study. Indian J Pediatr 82, 553–557 (2015). https://doi.org/10.1007/s12098-014-1678-y
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DOI: https://doi.org/10.1007/s12098-014-1678-y