Journal
JOURNAL OF PEDIATRIC SURGERY
Volume 46, Issue 6, Pages 1034-1040Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2011.03.025
Keywords
Necrotizing enterocolitis; NEC; Near infrared spectroscopy; NIRS; A-NIRS; StO(2); Premature; Piglets
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Funding
- US Department of Agriculture [58-6250-6-001]
- Danish Research Councils (FOSU Committee)
- Texas Medical Center Digestive Diseases Center [P30 DK-56338]
- National Institute of General Medical Sciences [GM-069912]
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Purpose: A major objective of necrotizing enterocolitis (NEC) research is to devise a noninvasive method of early detection. We hypothesized that abdominal near-infrared spectroscopy (A-NIRS) readings will identify impending NEC in a large animal model. Methods: Piglets were prematurely delivered and received parenteral nutrition followed by enteral feedings. Serial A-NIRS readings were obtained for 5 days, and animals were monitored for NEC. Separately, A-NIRS readings were obtained in healthy piglets to validate the correlation of A-NIRS with splanchnic oxygen delivery. Results: Of 29 piglets, 3 developed NEC. Eleven piglets without NEC died prematurely. Fifteen piglets remained healthy, had normal histologic assessment of their intestines, and served as controls. Abdominal near-infrared spectroscopy readings within 12 hours of birth were significantly lower in animals that developed NEC compared with healthy littermates (4% vs 33%, P = .02). For all time-points measured, A-NIRS readings were significantly lower in the NEC group compared with controls (21% vs 55%, P < .001). Abdominal near-infrared spectroscopy readings correlated with both decreased pulse oximetry readings during apneic episodes (r = 0.96) and increased superior mesenteric artery flow in response to glucagon-like peptide 2 (r = 0.67). Conclusion: Abdominal near-infrared spectroscopy is capable of detecting alterations in intestinal oxygenation and perfusion in neonatal piglets and may allow early detection of neonates at risk for NEC. (C) 2011 Elsevier Inc. All rights reserved.
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