Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Factors that influence mesenteric artery blood flow velocity in newborn preterm infants

Journal of Perinatology volume 26, pages 493–497 (2006)Cite this article

Abstract

Objectives:

To identify demographic and clinical variables that relate to the postnatal increase in intestinal blood flow velocity in preterm infants.

Study design:

Fasting or preprandial peak systolic velocity (PSV) and time-averaged mean velocity (TAMV) in the superior mesenteric artery were measured once each day for the first 5 days of life. We investigated the relationship between blood flow velocity and the following variables: birth weight, gestational age, feeding volumes, number of days to reach full feeding volumes, type of feeding given, continuous positive airway pressure (CPAP) administration and hyperalimentation (HAL) administration.

Results:

Twenty-five infants with a mean birth weight of 1740 g and mean gestational age of 31.8 weeks were studied. There were significant increases in PSV (P<0.001) and TAMV (P=0.005) from postnatal day 1 to 5. The postnatal increase in TAMV and PSV was attenuated in infants administered CPAP or HAL for ⩾3 days; the results remained significant after controlling for birth weight and gestational age. There was a significant correlation (P<0.02) between volume of enteral feedings given on 2 of 5 days for TAMV, and on 1 of 5 days for PSV.

Conclusions:

These data support previous findings of significant increases in intestinal blood flow in preterm infants during the first week of life, and of inconsistent effects of enteral feeding volumes on fasting or preprandial intestinal blood flow. The reasons for, and the clinical implications of, attenuated increases in postnatal intestinal blood flow in infants on CPAP or HAL require further investigation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

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

    Article  Google Scholar 

  2. Robel-Tillig E, Knupfer M, Pulzer F, Vogtmann C . Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants. Pediatr Radiol 2004.

  3. Maruyama K, Koizumi T, Tomomasa T, Morikawa A . Intestinal blood-flow velocity in uncomplicated preterm infants during the early neonatal period. Pediatr Radiol 1999; 29: 472–477.

    Article  CAS  Google Scholar 

  4. Fang S, Kempley ST, Gamsu HR . Prediction of early tolerance to enteral feeding in preterm infants by measurement of superior mesenteric artery blood flow velocity. Arch Dis Child Fetal Neonat Ed 2001; 85: F42–F45.

    Article  CAS  Google Scholar 

  5. Matheson PJ, Wilson MA, Garrison RN . Regulation of intestinal blood flow. J Surg Res 2000; 93: 182–196.

    Article  CAS  Google Scholar 

  6. Jacobson E . The splanchnic circulation. In: Johnson L (ed). Gastrointestinal Physiology. Mosby Year Book: St Louis, MO, 1991, pp 142–161.

    Google Scholar 

  7. Carver JD, Saste M, Sosa R, Zaritt J, Kuchan M, Barness LA . The effects of dietary nucleotides on intestinal blood flow in preterm infants. Pediatr Res 2002; 52: 425–429.

    Article  CAS  Google Scholar 

  8. Leidig E . Doppler analysis of superior mesenteric artery blood flow in preterm infants. Arch Dis Child 1989; 64: 476–480.

    Article  CAS  Google Scholar 

  9. Martinussen M, Brubakk AM, Vik T, Yao AC . Mesenteric blood flow velocity and its relation to transitional circulatory adaptation in appropriate for gestational age preterm infants. Pediatr Res 1996; 39: 275–280.

    Article  CAS  Google Scholar 

  10. Yanowitz TD, Yao AC, Pettigrew KD, Werner JC, Oh W, Stonestreet BS . Postnatal hemodynamic changes in very-low-birthweight infants. J Appl Physiol 1999; 87: 370–380.

    Article  CAS  Google Scholar 

  11. Van Bel F, Van Zoeren D, Schipper J, Guit GL, Baan J . Effect of indomethacin on superior mesenteric artery blood flow velocity in preterm infants. J Pediatr 1990; 116: 965–970.

    Article  CAS  Google Scholar 

  12. Coombs RC, Morgan MEI, Durbin GM, Booth IW, McNeish ASl . Gut blood flow velocities in the newborn: effects of patent ductus arteriosus and parenteral indomethacin. Arch Dis Child 1990; 65: 1067–1071.

    Article  CAS  Google Scholar 

  13. Hoecker C, Nelle M, Poeschl J, Beedgen B, Lindercamp O . Caffeine impairs cerebral and intestinal blood flow velocity in preterm infants. Pediatrie 2002; 109: 784–787.

    Article  Google Scholar 

  14. Lane AJP, Coombs RC, Evans DH, Levin RJ . Effect of caffeine on neonatal splanchnic blood flow. Arch Dis Child Fetal Neonat Ed 1999; 80: F128–F129.

    Article  CAS  Google Scholar 

  15. Van Bel F, Van Zwieten PHT, Guit GL, Schipper J . Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates. Radiology 1990; 174: 165–169.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  17. Coombs RC, Morgan MEI, Durbin GM, Booth IW, McNeish AS . Doppler assessment of human neonatal gut blood flow velocities: postnatal adaptation and response to feeds. J Pediatr Gastr Nutr 1992; 15: 6–12.

    Article  CAS  Google Scholar 

  18. Coombs RC, Morgan MEI, Durbin GM, Booth IW, McNeish AS . Abnormal gut blood flow velocities in neonates at risk of necrotising enterocolitis. J Pediatr Gastr Nutr 1992; 15: 13–19.

    Article  CAS  Google Scholar 

  19. Aly H, Milner JD, Patel K, El-Mohandes AA . Does the experience with the use of nasal continuous positive airway pressure improve over time in extremely low birth weight infants? Pediatrics 2004; 114: 697–702.

    Article  Google Scholar 

  20. Meyer M, Mildenhall L, Wong M . Outcomes for infants weighing less than 1000 grams cared for with a nasal continuous positive airway pressure-based strategy. J Paediatr Child Health 2004; 40: 38–41.

    Article  CAS  Google Scholar 

  21. De Paoli AG, Morley C, Davis PG . Nasal CPAP for neonates: what do we know in 2003? Arch Dis Child Fetal Neonat Ed 2003; 88: F168–F172.

    Article  CAS  Google Scholar 

  22. Jaile JC, Levin T, Wung JT, Abramson SJ, Ruzal-Shapiro C, Berdon WE . Benign gaseous distension of the bowel in premature infants treated with nasal continuous airway pressure: a study of contributing factors. AJR Am J Roentgenol 1992; 158: 125–127.

    Article  CAS  Google Scholar 

  23. Oste M, Van Ginneken CJ, Van Haver ER, Bjornvad CR, Thymann T, Sangild P . The intestinal trophic response to enteral food is reduced in parenterally fed preterm pigs and is associated with more nitrergic neurons. J Nutr 2005; 135: 2657–2663.

    Article  CAS  Google Scholar 

  24. Nankervis CA, Reber KM, Nowicki PT . Age-dependent changes in the postnatal intestinal microcirculation. Microcirculation 2001; 8: 377–387.

    Article  CAS  Google Scholar 

  25. Freeman-Ladd M, Cohen JB, Carver JD, Huhta JC . The hemodynamic effects of neonatal patent ductus arteriosus shunting on superior mesenteric artery blood flow. J Perinatol 2005; 25: 459–462.

    Article  Google Scholar 

Download references

Acknowledgements

We acknowledge the cardiology technicians, Patrick Johanboeke and Chris Madramootoo, who performed the ultrasound measurements for this study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, University of South Florida College of Medicine, USF Pediatrics, Tampa, FL, USA

    T Havranek & J D Carver

  2. Department of Epidemiology and Biostatistics, Center for Collaborative Research, University of South Florida College of Public Health, Tampa, FL, USA

    Z Thompson

Authors
  1. T Havranek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Z Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J D Carver
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T Havranek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Havranek, T., Thompson, Z. & Carver, J. Factors that influence mesenteric artery blood flow velocity in newborn preterm infants. J Perinatol 26, 493–497 (2006). https://doi.org/10.1038/sj.jp.7211551

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211551

Keywords

This article is cited by

Search

Advanced search

Quick links