Hemodynamics of superior mesenteric artery by doppler flow velocimetry in enterally fed moderately asphyxiated newborns

Introduction: Asphyxia is an important cause of neonatal mortality and morbidity. The disturbed hemodynamics caused by asphyxia can damage a number of organ systems including gastrointestinal system. Enteral feedings can therefore be risky in the asphyxiated newborns with jeopardized blood supply. Objective: The objective of this study was to estimate the abnormal Doppler flow indices of splanchnic circulation in moderately asphyxiated term newborns on the 1st day of life. Design: This was a prospective case-control study. Study setting: This study was conducted in the Neonatology Division, Department of Pediatrics and Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. Materials and Methods: This study included thirty hemodynamically stable asphyxiated babies as cases. The controls were gestation- as well as weight-matched normal newborns. Blood flow in the superior mesenteric artery (SMA) was estimated by Doppler ultrasonography within the first 24 h of birth of the baby. The peak systolic velocity, end-diastolic velocity, time-averaged mean velocity, and the resistive index were recorded. The measurement was done before and 1 h after giving feed to the baby. The pre- and postfeed Doppler indices of the SMA were measured and compared with the controls. The tolerance of oral feeds by the babies was regularly monitored. Results: The baseline velocity in the study group prior to feeding was comparable to the control group. None of the cases developed feed intolerance and showed a similar postfeed hemodynamic response in the SMA as that of controls. Conclusion: Enteral feeds could be safely started and continued in all the moderately asphyxiated term neonates within the 1st day of life after demonstrating establishment of splanchnic flow in the Doppler study.