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  • Original Article
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Umbilical artery catheters do not affect intestinal blood flow responses to minimal enteral feedings

Journal of Perinatology volume 27, pages 375–379 (2007)Cite this article

Abstract

Objective:

To investigate the effects of umbilical artery catheters (UACs) on superior mesenteric artery (SMA) blood flow velocity (BFV) following enteral feedings in very low birth weight preterm infants.

Study design:

Very low birth weight preterm infants who had UACs inserted as part of standard clinical care were enrolled in this prospective study. On the day the UAC was scheduled to be removed, pre- and postprandial SMA BFV (mean, peak systolic and end diastolic velocities) were measured in conjunction with a minimal enteral feeding given while the UAC was in place. The same measurements were made with the next feeding given after the UAC was removed. Preprandial measurements were made at least 3 h after the last enteral feeding, and postprandial measurements were made 30, 45 and 60 min after the feeding began. The same volume and type of feeding were used for both studies.

Results:

The birth weight and gestational age of the 19 infants who completed the study were 1014±221 g and 27.4±1.9 weeks, respectively. Infants were 4.6±1.7-days-old when the first SMA BFV measurement was made, the volume of enteral feedings was 1.3±0.6 ml, and the time between the two enteral feedings was 4.7±3.2 h. Preprandial SMA BFV did not differ with the UAC in place compared with the UAC removed. Peak postprandial velocities were at 45 min after feedings began. The percent increase from baseline was not significantly different with the UAC in place compared with the UAC removed.

Conclusions:

Preprandial SMA BFV and postprandial SMA BFV responses to minimal enteral feedings were not affected by the presence of a UAC.

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References

  1. Havranek T, Thompson Z, Carver JD . Factors that influence mesenteric artery blood flow velocity in newborn preterm infants. J Perinatol 2006; 26: 493–497.

    Article  CAS  Google Scholar 

  2. 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 

  3. Martinussen M, Brubakk AM, V 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 

  4. 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 

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

    Article  CAS  Google Scholar 

  6. 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 

  7. 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 Neonatal Ed 2001; 85: F42–F45.

    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. 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 

  10. Coombs RC, Morgan MEI, Durbin GM, Booth IW, McNeish AS . 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 

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

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  13. 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 

  14. Yao AC, Martinussen M, Johansen OJ, Brubakk AM . Phototherapy-associated changes in mesenteric blood flow response to feeding in term neonates. J Pediatr 1994; 124: 309–312.

    Article  CAS  Google Scholar 

  15. Pezzati M, Biagiotti R, Vangi V, Lombardi E, Wiechmann L, Rubaltelli FF . Changes in mesenteric blood flow response to feeding: conventional versus fiber-optic phototherapy. Pediatrics 2000; 105: 350–353.

    Article  CAS  Google Scholar 

  16. Kempley ST, Gamsu HR . Randomised trial of umbilical arterial catheter position: Doppler ultrasound findings. Arch Dis Child 1992; 67: 855–859.

    Article  CAS  Google Scholar 

  17. Rand T, Weninger M, Kohlhauser C, Bischof S, Heinz-Peer G, Trattnig S et al. Effects of umbilical arterial catheterization on mesenteric hemodynamics. Pediatr Radiol 1996; 26: 435–438.

    Article  CAS  Google Scholar 

  18. Mokrohisky ST, Levine RL, Blumhagen JD, Wesenberg RL, Simmons MA . Low positioning of umbilical-artery catheters increases associated complications in newborn infants. N Engl J Med 1978; 299: 561–564.

    Article  CAS  Google Scholar 

  19. Wesstrom G, Finnstrom O, Stenport G, Tyson JE, deSa DJ, Moore S . Umbilical artery catheterization in newborns. I. Thrombosis in relation to catheter type and position Thromboatheromatous complications of umbilical arterial catheterization in the newborn period. Clinicopathological study. Acta Paediatr Scand 1979; 68: 575–581.

    Article  CAS  Google Scholar 

  20. Tyson JE, deSa DJ, Moore S . Thromboatheromatous complications of umbilical arterial catheterization in the newborn period. Clinicopathological study. Arch Dis Child 1976; 51: 744–754.

    Article  CAS  Google Scholar 

  21. Roll C, Hanssler L . Effect of umbilical arterial catheters on intestinal blood supply. Acta Paediatr 1998; 87: 955–959.

    Article  CAS  Google Scholar 

  22. Shah JB, Bracero LA, Gewitz MH, Fish BG, Dweck HS . Umbilical artery catheters and blood flow velocities in the superior mesenteric artery: effect of insertion, removal, aspiration, and bolus infusion. J Clin Ultrasound 1998; 26: 73–77.

    Article  CAS  Google Scholar 

  23. Ranade D . Nutritional management. In: Gomella T, Cunningham M, Eyal F, KE Z (eds). Neonatology. Lange Medical Books: New York, 1999, p 78.

    Google Scholar 

  24. Short-Bartlett S . Arterial catherization. In: Taeusch H, Christiansen R, Buescher E (eds). Pediatric and Neonatal Tests and Procedures. W.B. Saunders: Philadelphia, PA, 1996, p 168.

    Google Scholar 

  25. Pierce J, Turner B . Physiologic monitoring. In: Merenstein J, Gardner S (eds). Handbook of Neonatal Intensive Care. 4 ed. Mosby: St Louis, MO, 1998, p 128.

    Google Scholar 

  26. 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 

  27. Kempley ST, Gamsu HR . Superior mesenteric artery blood flow velocity in necrotising enterocolitis. Arch Dis Child 1992; 67: 793–796.

    Article  CAS  Google Scholar 

  28. Tiffany KF, Burke BL, Collins-Odoms C, Oelberg DG . Current practice regarding the enteral feeding of high-risk newborns with umbilical catheters in situ. Pediatrics 2003; 112: 20–23.

    Article  Google Scholar 

  29. Pezzati M, Dani C, Tronchin M, Filippi L, Rossi S, Rubaltelli FF . Prediction of early tolerance to enteral feeding by measurement of superior mesenteric artery blood flow velocity: appropriate- versus small-for-gestational-age preterm infants. Acta Paediatr 2004; 93: 797–802.

    Article  CAS  Google Scholar 

  30. Gladman G, Sims DG, Chiswick ML . Gastrointestinal blood flow velocity after the first feed. Arch Dis Child 1991; 66: 17–20.

    Article  CAS  Google Scholar 

  31. 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 

  32. Wong SN, Lo RN, Hui PW . Abnormal renal and splanchnic arterial Doppler pattern in premature babies with symptomatic patent ductus arteriosus. J Ultrasound Med 1990; 9: 125–130.

    Article  CAS  Google Scholar 

  33. Lemons JA, Bauer CR, Oh W, Korones SB, Papile L, Stoll BJ et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics 2001; 107: e1–e11.

    Article  CAS  Google Scholar 

  34. Clark RH, Thomas P, Peabody J . Extrauterine growth restriction remains a serious problem in prematurely born neonates. Pediatrics 2003; 111: 986–990.

    Article  Google Scholar 

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

    Article  Google Scholar 

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Authors and Affiliations

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

    T Havranek, P Johanboeke, C Madramootoo & J D Carver

  2. Siemens Medical Solutions, Tampa, FL, USA

    P Johanboeke

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  1. T Havranek
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  4. J D Carver
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Correspondence to T Havranek.

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Havranek, T., Johanboeke, P., Madramootoo, C. et al. Umbilical artery catheters do not affect intestinal blood flow responses to minimal enteral feedings. J Perinatol 27, 375–379 (2007). https://doi.org/10.1038/sj.jp.7211691

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