Prediction of necrotizing enterocolitis in very low birth weight infants by superior mesenteric artery ultrasound of postnatal day 1: A nested prospective study

作者全名："Yue, Guang; Wang, Jun; Yang, Sheng; Deng, Ying; Wen, Yang; Jia, Wen; Cao, Huiling; Ju, Rong; Shi, Yuan"

作者地址："[Yue, Guang; Shi, Yuan] Chongqing Med Univ, Childrens Hosp, Chongqing Key Lab Child Infect & Immun, Chongqing, Peoples R China; [Yue, Guang; Jia, Wen; Cao, Huiling; Shi, Yuan] Chongqing Med Univ, Childrens Hosp, Neonatal Dept, Chongqing, Peoples R China; [Yue, Guang; Shi, Yuan] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China; [Yue, Guang; Shi, Yuan] Chongqing Med Univ, Childrens Hosp, Minist Educ Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Wang, Jun; Ju, Rong] Chengdu Womens & Childrens Cent Hosp, Neonatal Dept, Chongqing, Peoples R China; [Yang, Sheng; Deng, Ying; Wen, Yang] Chengdu Womens & Childrens Cent Hosp, Ultrasonog Dept, Chongqing, Peoples R China"

通信作者："Yue, G; Shi, Y (通讯作者)，Chongqing Med Univ, Childrens Hosp, Chongqing Key Lab Child Infect & Immun, Chongqing, Peoples R China.; Yue, G; Shi, Y (通讯作者)，Chongqing Med Univ, Childrens Hosp, Neonatal Dept, Chongqing, Peoples R China.; Yue, G; Shi, Y (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing, Peoples R China.; Yue, G; Shi, Y (通讯作者)，Chongqing Med Univ, Childrens Hosp, Minist Educ Key Lab Child Dev & Disorders, Chongqing, Peoples R China."

来源：FRONTIERS IN PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000921544200001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：doppler ultrasound; necrotizing enterocolitis; very low birth weight infant; prediction; superior mesenteric artery

摘要："BackgroundNecrotizing enterocolitis (NEC) is a devastating intestinal complication that occurs mainly in very-low-birth-weight infants (VLBWI). The study's aim was to investigate the possibility of early prediction of NEC on postnatal day 1 based on superior mesenteric artery (SMA) doppler ultrasonograpy. MethodsA prospective, observational, nested case control study (ChiCTR1900026197) was conducted to enroll VLBWIs (birth weight <1,500 grams) between October 2019 and September 2021. Doppler ultrasound measurement was done during the first 12 h of life and before first feeding. Infants developing NEC (stage II or III) subsequently were included in NEC group and infants spare of NEC were included in control group. Results370 VLBWIs were enrolled (30 NEC cases). Among the ultrasound parameters, S/D was significantly higher in the NEC group (OR: 2.081, 95% CI: 1.411-3.069, P = 0.000). The area under the receiver operating curve (AUROC) following the Logistic regression was 0.704 (95% CI: 0.566-0.842, P = 0.001). The sensitivity of S/D for predicting NEC was 52.2% and the specificity was 92.7%. The critical value of S/D was 6.944 and Youden index was 0.449. Preplanned subgroup analysis confirmed that NEC infants of different stages were characterized by different SMA bloodstream. Small for gestational age (SGA) might be a confounding factor affecting intestinal bloodflow. And infants with delayed initiation or slow advancement of feeding exhibited characteristic intestinal perfusion. ConclusionsIn VLBWI, early SMA ultrasound shows the potential to predict NEC. It is reasonable to speculate that SMA bloodstream is related to intestinal structural and functional integrity."

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