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Neonatal colour Doppler ultrasound study: normal values of abdominal blood flow velocities in the neonate during the first month of life

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Abstract

Background

Doppler US to measure abdominal blood flow velocities (ABFV) is increasingly used to investigate intestinal haemodynamics in several clinical conditions in neonates. Studies that provide reference values of ABFV during the entire neonatal period are currently lacking.

Objective

To make available normal reference values of ABFV and Doppler indices in the coeliac trunk and superior mesenteric artery during the first month of life in term and healthy preterm infants.

Materials and methods

ABFV were obtained with colour Doppler US in 69 neonates (12 term, 57 preterm) divided into four gestational age groups (25–28 weeks, 29–32 weeks, 33–36 weeks, and 37–41 weeks).

Results

ABFV increased with increasing gestational and postnatal age. We also provide normal reference values of ABFV and Doppler indices to compare with measurements of abdominal blood flow changes during the neonatal period for diagnostic, therapeutic and prognostic purposes.

Conclusion

These longitudinal reference values provide a useful tool for assessing possible alteration in ABFV secondary to neonatal pathologies.

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References

  1. Dietrich CF, Jedrzejczyk M, Ignee A (2007) Sonographic assessment of splanchnic arteries and the bowel wall. Eur J Radiol 64:204–212

    Article  Google Scholar 

  2. Perko MJ (2001) Duplex ultrasound for assessment of superior mesenteric artery blood flow. Eur J Vasc Endovasc Surg 21:106–117

    Article  PubMed  CAS  Google Scholar 

  3. Murdoch EM, Sinha AK, Shanmugalingam ST et al (2006) Doppler flow velocimetry in the superior mesenteric artery on the first day of life in preterm infants and the risk of neonatal necrotizing enterocolitis. Pediatrics 118:1999–2003

    Article  PubMed  Google Scholar 

  4. Leidig E (1989) Pulsed Doppler ultrasound blood flow measurements in the superior mesenteric artery of the newborn. Pediatr Radiol 19:169–172

    Article  PubMed  CAS  Google Scholar 

  5. Van Bel F, Van Zwieten PH, Guit GL et al (1990) Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates. Radiology 174:165–169

    PubMed  Google Scholar 

  6. Maruyama K, Koizumi T, Tomomasa T et al (1999) Intestinal blood-flow velocity in uncomplicated preterm infants during the early neonatal period. Pediatr Radiol 29:472–477

    Article  PubMed  CAS  Google Scholar 

  7. Shanklin DR, Cooke RJ (1993) Effects of intrauterine growth on intestinal length in the human fetus. Biol Neonate 64:76–81

    PubMed  CAS  Google Scholar 

  8. Martinussen M, Brubakk AM, Vik T et al (1997) Relationship between intrauterine growth retardation and early postnatal superior mesenteric artery blood flow velocity. Biol Neonate 71:22–30

    PubMed  CAS  Google Scholar 

  9. Robel-Tillig E, Vogtmann C, Faber R (2000) Postnatal intestinal disturbances in small-for-gestational-age premature infants after prenatal haemodynamic disturbances. Acta Paediatr 89:324–330

    Article  PubMed  CAS  Google Scholar 

  10. Korszun P, Dubiel M, Breborowicz G et al (2002) Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy. J Perinat Med 30:235–241

    Article  PubMed  Google Scholar 

  11. Weir FJ, Ohlsson A, Fong K et al (1999) Does endothelin-1 reduce superior mesenteric artery blood flow velocity in preterm neonates? Arch Dis Child Fetal Neonatal Ed 80:F123–127

    PubMed  CAS  Google Scholar 

  12. Akinbi H, Abbasi S, Hilpert PL et al (1994) Gastrointestinal and renal blood flow velocity profile in neonates with birth asphyxia. J Pediatr 125:625–627

    Article  PubMed  CAS  Google Scholar 

  13. Robel-Tillig E, Vogtmann C, Bennek J (2002) Prenatal hemodynamic disturbances – pathophysiological background of intestinal motility disturbances in small for gestational age infants. Eur J Pediatr Surg 12:175–179

    Article  PubMed  CAS  Google Scholar 

  14. Kempley ST, Murdoch E (2000) Splanchnic haemodynamic disturbances in perinatal sepsis. Arch Dis Child Fetal Neonatal Ed 83:F139–142

    Article  PubMed  CAS  Google Scholar 

  15. Martinussen M, Brubakk AM, Linker DT et al (1994) Mesenteric blood flow velocity and its relation to circulatory adaptation during the first week of life in healthy term infants. Pediatr Res 36:334–339

    Article  PubMed  CAS  Google Scholar 

  16. Lane AJ, Coombs RC, Evans DH et al (1999) Effect of caffeine on neonatal splanchnic blood flow. Arch Dis Child Fetal Neonatal Ed 80:F128–129

    Article  PubMed  CAS  Google Scholar 

  17. Hoecker C, Nelle M, Poeschl J et al (2002) Caffeine impairs cerebral and intestinal blood flow velocity in preterm infants. Pediatrics 109:784–787

    Article  PubMed  Google Scholar 

  18. Hoecker C, Nelle M, Beedgen B et al (2006) Effects of a divided high loading dose of caffeine on circulatory variables in preterm infants. Arch Dis Child Fetal Neonatal Ed 91:F61–64

    Article  PubMed  CAS  Google Scholar 

  19. Soraisham AS, Elliott D, Amin H (2008) Effect of single loading dose of intravenous caffeine infusion on superior mesenteric artery blood flow velocities in preterm infants. J Paediatr Child Health 44:119–121

    Article  PubMed  Google Scholar 

  20. Feigen LP, King LW, Ray J et al (1981) Differential effects of ibuprofen and indomethacin in the regional circulation of the dog. J Pharmacol Exp Ther 219:679–684

    PubMed  CAS  Google Scholar 

  21. Grosfeld JL, Kamman K, Gross K et al (1983) Comparative effects of indomethacin, prostaglandin E1, and ibuprofen on bowel ischemia. J Pediatr Surg 18:738–742

    Article  PubMed  CAS  Google Scholar 

  22. Yao AC, Martinussen M, Johansen OJ et al (1994) Phototherapy-associated changes in mesenteric blood flow response to feeding in term neonates. J Pediatr 124:309–312

    Article  PubMed  CAS  Google Scholar 

  23. Pezzati M, Biagiotti R, Vangi V et al (2000) Changes in mesenteric blood flow response to feeding: conventional versus fiber-optic phototherapy. Pediatrics 105:350–353

    Article  PubMed  CAS  Google Scholar 

  24. Kadalraja R, Patole SK, Muller R et al (2004) Is mesenteric blood flow compromised during phototherapy in preterm neonates? Arch Dis Child Fetal Neonatal Ed 89:F564

    Article  PubMed  CAS  Google Scholar 

  25. Nelle M, Hocker C, Zilow EP et al (1994) Effects of red cell transfusion on cardiac output and blood flow velocities in cerebral and gastrointestinal arteries in premature infants. Arch Dis Child Fetal Neonatal Ed 71:F45–48

    Article  PubMed  CAS  Google Scholar 

  26. Lane AJ, Coombs RC, Evans DH et al (1998) Effect of feed interval and feed type on splanchnic haemodynamics. Arch Dis Child Fetal Neonatal Ed 79:F49–53

    PubMed  CAS  Google Scholar 

  27. Pourcelot L (1976) Diagnostic ultrasound for cerebral vascular disease. In: Donald I, Levis N (eds) Present and future of diagnostic ultrasound. Krooyker Science Publishers, Rotterdam, pp 141–171

    Google Scholar 

  28. Gosling RG, King DH (1974) Arterial assessment by Doppler-shift ultrasound. Proc R Soc Med 67:447–449

    PubMed  CAS  Google Scholar 

  29. Jager K, Bollinger A, Valli C et al (1986) Measurement of mesenteric blood flow by duplex scanning. J Vasc Surg 3:462–469

    Article  PubMed  CAS  Google Scholar 

  30. Weir FJ, Fong K, Ryan ML et al (1995) Superior mesenteric artery and renal artery blood flow velocity measurements in neonates: technique and interobserver reliability. Pediatr Radiol 25:145–148

    Article  PubMed  CAS  Google Scholar 

  31. Reber KM, Nankervis CA, Nowicki PT (2002) Newborn intestinal circulation. Physiology and pathophysiology. Clin Perinatol 29:23–39

    Article  PubMed  Google Scholar 

  32. Gladman G, Sims DG, Chiswick ML (1991) Gastrointestinal blood flow velocity after the first feed. Arch Dis Child 66:17–20

    Article  PubMed  CAS  Google Scholar 

  33. Fang S, Kempley ST, Gamsu HR (2001) Prediction of early tolerance to enteral feeding in preterm infants by measurement of superior mesenteric artery blood flow velocity. Arch Dis Child Fetal Neonatal Ed 85:F42–45

    Article  PubMed  CAS  Google Scholar 

  34. Pezzati M, Dani C, Tronchin M et al (2004) Prediction of early tolerance to enteral feeling by measurement of superior mesenteric artery blood flow velocity: appropriate versus small-for-gestational-age preterm infants. Acta Pediatr 93:797–802

    Article  CAS  Google Scholar 

  35. Robel-Tillig E, Knupfer M, Pulzer F et al (2004) Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants. Pediatr Radiol 34:958–962

    Article  PubMed  Google Scholar 

  36. Maruyama K, Koizumi T (2001) Superior mesenteric artery blood flow velocity in small for age infants of very low birth weight during the early neonatal period. J Perinat Med 29:64–70

    Article  PubMed  CAS  Google Scholar 

  37. Wong SN, Lo RN, Hui PW (1990) Abnormal renal and splanchnic arterial Doppler pattern in premature babies with symptomatic patent ductus arteriosus. J Ultrasound Med 9:125–130

    PubMed  CAS  Google Scholar 

  38. Coombs RC, Morgan ME, Durbin GM et al (1992) Abnormal gut blood flow velocities in neonates at risk of necrotising enterocolitis. J Pediatr Gastroenterol Nutr 15:13–19

    Article  PubMed  CAS  Google Scholar 

  39. Kempley ST, Gamsu HR (1992) Superior mesenteric artery blood flow velocity in necrotising enterocolitis. Arch Dis Child 67:793–796

    Article  PubMed  CAS  Google Scholar 

  40. Deeg KH, Rupprecht T, Schmid E (1993) Doppler sonographic detection of increased flow velocities in the celiac trunk and superior mesenteric artery in infants with necrotizing enterocolitis. Pediatr Radiol 23:578–582

    Article  PubMed  CAS  Google Scholar 

  41. Nowicki PT, Nankervis CA (1994) The role of the circulation in the pathogenesis of necrotizing enterocolitis. Clin Perinatol 21:219–234

    PubMed  CAS  Google Scholar 

  42. Grosfeld JL, Chaet M, Molinari F et al (1996) Increased risk of necrotizing enterocolitis in premature infants with patent ductus arteriosus treated with indomethacin. Ann Surg 224:350–355

    Article  PubMed  CAS  Google Scholar 

  43. Coombs RC, Morgan ME, Durbin GM et al (1990) Gut blood flow velocities in the newborn: effects of patent ductus arteriosus and parenteral indomethacin. Arch Dis Child 65:1067–1071

    Article  PubMed  CAS  Google Scholar 

  44. Yanowitz TD, Yao AC, Werner JC et al (1998) Effects of prophylactic low-dose indomethacin on hemodynamics in very low birth weight infants. J Pediatr 132:28–34

    Article  PubMed  CAS  Google Scholar 

  45. Christmann V, Liem KD, Semmekrot BA et al (2002) Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin. Acta Paediatr 91:440–446

    Article  PubMed  CAS  Google Scholar 

  46. Hentschel R, Hensel D, Brune T et al (1995) Impact on blood pressure and intestinal perfusion of dobutamine or dopamine in hypotensive preterm infants. Biol Neonate 68:318–324

    Article  PubMed  CAS  Google Scholar 

  47. Seri I, Abbasi S, Wood DC et al (2002) Regional hemodynamic effects of dopamine in the indomethacin-treated preterm infant. J Perinatol 22:300–305

    Article  PubMed  Google Scholar 

  48. Kempley ST, Gamsu HR (1992) Randomised trial of umbilical arterial catheter position: Doppler ultrasound findings. Arch Dis Child 67:855–859

    Article  PubMed  CAS  Google Scholar 

  49. Davey AM, Wagner CL, Cox C et al (1994) Feeding premature infants while low umbilical artery catheters are in place: a prospective, multicenter trial. J Pediatr 124:795–799

    Article  PubMed  CAS  Google Scholar 

  50. Rand T, Weninger M, Kohlhauser C et al (1996) Effects of umbilical arterial catheterisation on mesenteric hemodynamics. Pediatr Radiol 26:435–438

    Article  PubMed  CAS  Google Scholar 

  51. Roll C, Hanssler L (1998) Effect of umbilical arterial catheters on intestinal blood supply. Acta Paediatr 87:955–959

    Article  PubMed  CAS  Google Scholar 

  52. Shah JB, Bracero LA, Gewitz MH et al (1998) Umbilical artery catheters and blood flow velocities in the superior mesenteric artery: effect of insertion, removal, aspiration, and bolus infusion. J Clin Ultrasound 26:73–77

    Article  PubMed  CAS  Google Scholar 

  53. Havranek T, Johanboeke P, Madramootoo C et al (2007) Umbilical artery catheters do not affect intestinal blood flow responses to minimal enteral feedings. J Perinatol 27:375–379

    Article  PubMed  CAS  Google Scholar 

  54. Kadalraja R, Patole SK, Muller R et al (2004) Is mesenteric blood flow compromised during phototherapy in preterm neonates? Arch Dis Child Fetal Neonatal Ed 89:F564

    Article  PubMed  CAS  Google Scholar 

  55. Havranek T, Madramootoo C, Carver JD (2007) Nasal continuous positive airway pressure affects pre- and postprandial intestinal blood flow velocity in preterm infants. J Perinatol 27:704–708

    Article  PubMed  CAS  Google Scholar 

  56. Havranek T, Thompson Z, Carver JD (2006) Factors that influence mesenteric artery blood flow velocity in newborn preterm infants. J Perinatol 26:493–497

    Article  PubMed  CAS  Google Scholar 

  57. Reber KM, Mager GM, Miller CE et al (2001) Relationship between flow rate and NO production in postnatal mesenteric arteries. J Physiol Gastrointest Liver Physiol 280:G43–G50

    CAS  Google Scholar 

  58. Shigeru I, Brawley L, Wheeler T et al (2002) Vasodilatation to vascular endothelial growth factor in the uterine artery of the pregnant rat is blunted by low dietary protein intake. Pediatr Res 51:485–491

    Article  Google Scholar 

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Correspondence to Patrizia Papacci.

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Papacci, P., Giannantonio, C., Cota, F. et al. Neonatal colour Doppler ultrasound study: normal values of abdominal blood flow velocities in the neonate during the first month of life. Pediatr Radiol 39, 328–335 (2009). https://doi.org/10.1007/s00247-008-1112-6

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  • DOI: https://doi.org/10.1007/s00247-008-1112-6

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