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Doppler ultrasound assessment of the splanchnic circulation in preterms with neonatal sepsis at risk for necrotizing enterocolitis

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Abstract

Objective

To evaluate the role of Doppler ultrasonography in the assessment of splanchnic circulation’s hemodynamic changes in septic preterms at risk of necrotizing enterocolitis.

Methods

A total of 51 septic preterms were divided into two groups: 25 preterms with clinical signs of necrotizing enterocolitis (NEC) and 26 preterms with no clinical signs of NEC. Both groups were assessed with Doppler ultrasonography of the celiac and superior mesenteric arteries, and each septic preterm’s peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI) was calculated and recorded.

Results

These included a statistically significant lower PSV (p: 0.001) and a lower EDV (p: 0.001) in the superior mesenteric artery in the septic group with clinical signs of NEC in comparison with the septic group with no clinical signs of NEC. A statistically significant (p < 0.001) higher PSV celiac (CA)/PSV superior mesenteric (SMA) ratio was found for the group of septic preterms with clinical signs of NEC when compared to the other group.

Conclusion

The study results showed that Doppler ultrasonography of the splanchnic circulation can be a tool for the early identification of NEC cases among septic preterms.

Sommario

Obiettivo

valutare il ruolo del Doppler nella valutazione dei cambiamenti emodinamici del circolo splancnico in pz pretermine settiche e a rischio di enterocolite necrotizzante.

Metodi

51 pazienti pretermine settiche divise in due gruppi sia con segni clinici di enterocolite necrotizzante (NEC) o asintomatiche, entrambi valutati con Doppler a ultrasuoni delle arterie celiaca e mesenterica superiore, con velocità di picco sistolico (PSV), fine della velocità diastolica (EDV), indice di resistività (RI), indice di pulsatilità (PI) il calcolo e la registrazione.

Risultati

il più basso PSV è risultato statisticamente significativo (p: 0.001), il valore inferiore di EDV (p: 0.001) campionati a livello dell’arteria mesenterica superiore nel gruppo settico con segni clinici di NEC, a confronto con il gruppo delle settiche senza segni clinici di NEC. Statisticamente significativa (p < 0.001) l’aumento del rapporto PSV celiaco (CA)/PSV a livello della mesenterica superiore (SMA) nel gruppo di sepsi con segni clinici di NEC in confronto con l’altro gruppo.

Conclusione

I risultati dello studio hanno mostrato che il Doppler del circolo splancnico può essere uno strumento di identificazione precoce dei casi NEC tra le pazienti pretermine settiche.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt

    Yasmeen A. Mansi, Nehal S. Almasah & Shereen Abdelghaffar

  2. Department of Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Rania H. Hashem

Authors
  1. Rania H. Hashem
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  2. Yasmeen A. Mansi
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  3. Nehal S. Almasah
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  4. Shereen Abdelghaffar
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Correspondence to Rania H. Hashem.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hashem, R.H., Mansi, Y.A., Almasah, N.S. et al. Doppler ultrasound assessment of the splanchnic circulation in preterms with neonatal sepsis at risk for necrotizing enterocolitis. J Ultrasound 20, 59–67 (2017). https://doi.org/10.1007/s40477-016-0228-z

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  • DOI: https://doi.org/10.1007/s40477-016-0228-z

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