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Title: Can non-invasive measurement of gut oxygenation predict necrotizing enterocolitis in preterm infants?

item PATEL, ASHISH - Texas Children'S Hospital
item OLUTOYE, OLUYINKA - Texas Children'S Hospital
item Burrin, Douglas - Doug
item BRANDT, MARY - Texas Children'S Hospital

Submitted to: Pediatric Academic Society
Publication Type: Abstract Only
Publication Acceptance Date: 4/1/2009
Publication Date: 5/1/2009
Citation: Patel, A.K., Olutoye, O., Burrin, D.G., Brandt, M.L. 2009. Can non-invasive measurement of gut oxygenation predict necrotizing enterocolitis in preterm infants [abstract]? Proceedings of the Pediatric Academic Societies Annual Meeting, May 2-5, 2009, Baltimore, Maryland. Paper No. 4350.356.

Interpretive Summary:

Technical Abstract: Factors that contribute to the development of NEC include hypoperfusion or decreased oxygenation of splanchnic tissue. Near-Infrared Spectroscopy (NIRS) will be used to assess gut oxygenation non-invasively. Typically NIRS is primarily used for cerebral hemodynamic monitoring; we intend to apply it to the abdomen to monitor gut oxygenation. The objective of this study is to determine normal values for gut oxygenation in preterm infant and to determine if low gut oxygenation predicts the subsequent development of NEC. We hypothesize that NIRS may be able to predict NEC in high-risk preterm infants. We are conducting a pilot prospective cohort study on preterm infants at risk for NEC. Inclusion criteria are healthy preterm infants <32 weeks gestational age and <1500 grams birth weight. Infants are enrolled within the first 24 hours of life. Exclusion criteria are infants with congenital anomalies or terminally ill. After informed consent was obtained, gut oxygenation was recorded for 5 minutes daily for the first 7 postnatal days, then weekly for 4 weeks using InSpectra StO2 NIRS (Hutchinson Technology). NIRS probe was placed on right lower abdominal quadrant. Enterally fed infants have 5-minute recordings taken before, during, and 60 minutes after feeds. We have studied 83 infants (Avg BW 1060 grams and GA 28.5 wks), of whom 13 have developed medical (8), surgical NEC (1), or died (4). Mean (+/-SEM) StO2 values on day of life 1 was lower in NEC vs. non-NEC patients (60.7% +/- 13.2 vs 72.8% +/- 2.8; P=0.075). StO2 values associated with enteral feedings (before, during, and after feeding) have not shown a difference between the two groups. We have successfully measured gut oxygenation with NIRS in preterm infants. Lower StO2 values on day of life 1 may be useful to predict NEC in high-risk patients.