Feeding Tolerance, Intestinal Motility, and Superior Mesenteric Artery Blood Flow in Infants with Gastroschisis.

Sadie L Williams, Jean A Tkach, Mantosh S Rattan, Andrew P South, Jacqueline Wessel, Paul S Kingma

Journal: Neonatology 2020;117(1):95-101

PMID: 31851996

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Abstract

OBJECTIVE

The aim of this study was to determine the relationship of superior mesenteric artery (SMA) blood flow and intestinal motility with feeding tolerance in infants with gastroschisis.

STUDY DESIGN

This was a prospective observational cohort study of 23 infants with gastroschisis. Magnetic resonance images were obtained at abdominal wall closure, initiation of feeds, and full feeds. Motility and SMA flow data were correlated with feeding tolerance.

RESULT

All infants had abnormal motility, and most continued with abnormal motility despite achieving full feeds. Increased SMA flow at the time of abdominal wall closure was found to be significantly related to the earlier achievement of full feeds (ρ = -0.45, p = 0.05) and trended towards earlier initiation of feeds (ρ = -0.36, p = 0.13), shorter parenteral nutrition days (ρ = -0.42, p = 0.07), and earlier discharge (ρ = -0.41, p = 0.08).

CONCLUSION

Increased SMA blood flow at the time of abdominal wall closure is positively correlated with feeding tolerance, suggesting the importance of initial intestinal perfusion in the pathophysiology for feeding intolerance and intestinal dysmotility in gastroschisis.

Address: The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Imaging Research Center and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Division of Neonatology, Children's Hospital Medical Center of Akron, Akron, Ohio, USA.; Division of Nutrition Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA, [email protected].; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA, [email protected].; Cincinnati Fetal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA, [email protected].

DOI: 10.1159/000504226

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https://doi.org/10.1159/000504226

MeSH Terms: Female, Gastrointestinal Motility, Gastroschisis, Gestational Age, Humans, Infant, Infant, Newborn, Infant, Premature, Length of Stay, Magnetic Resonance Imaging, Male, Mesenteric Artery, Superior, Parenteral Nutrition, Total, Patient Discharge, Prospective Studies, Time Factors