Optimal Timing for the Initiation of Enteral Feeding in Neonates with Gastroschisis, Depending on Non-Invasive Doppler Ultrasound Evaluation of Hemodynamics in the Bowel Wall ArteriesOV Teplyakova1*, EA Filippova2, YL Podurovskaya2, AV Pyregov2, VV Zubkov2, AA Burov2, EI Dorofeeva2 and MI Pykov3
- *Corresponding Author:
- Teplyakova OV
Surgery, Resuscitation and Intensive Care Department, Research Centre for Obstetrics
Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Moscow, Russia
E-mail: [email protected]
Received date: December 21, 2016; Accepted date: January 28, 2017; Published date: January 31, 2017
Citation: Teplyakova OV, Filippova EA, Filippova YL, Pyregov AV, Zubkov VV, et al. (2017) Optimal Timing for the Initiation of Enteral Feeding in Neonates with Gastroschisis, Depending on Non-Invasive Doppler Ultrasound Evaluation of Hemodynamics in the Bowel Wall Arteries. J Anesth Clin Res 8:701. doi: 10.4172/2155-6148.1000701
Copyright: © 2017 Teplyakova OV, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: The objective of the study is to assess the clinical relevance of ultrasonography evaluation of hemodynamics in the bowel wall arteries for determining the optimal time of the initiation of enteral feeding in neonates with gastroschisis.
Patients and methods: The sample consisted of 28 newborns with gastroschisis. Doppler ultrasonography was used to evaluate hemodynamic patterns in the bowel wall arteries in the pre- and postop periods to determine the optimal time for the initiation of enteral nutrition. Swelling of the bowel wall and indefinite differentiation into layers were observed during the first 2-3 days upon gastroschisis surgery. The blood flow in the intestinal wall arteries was varying in different quadrants, demonstrating a mosaic pattern. Hyperemia, i.e. a dramatic blood flow increase, was documented. The peripheral resistance dropped with RI equal to 0.49-0.54, but there were also areas with definite RI increases up to 0.85. By days 5-6 of life, the intestinal wall still remained moderately thickened. The resistive index (RI) values for the intestinal wall arteries were approaching the norm, ranging from 0.58 to 0.72. By days 7-9 after birth, the bowel loops remained slightly thickened, but already gained a clear differentiation into layers. The peripheral resistance indices were within the normal limits, ranging from 0.62 to 0.67.
Results: In our study RI values based on Doppler evaluation of the intestinal wall hemodynamics were within 0.62-0.67.
Conclusions: The hemodynamic parameters were consistent with clinical characteristics of the normal passage of food through the digestive tract. Thus, a physician can rely on both clinical signs and ultrasonography data while monitoring the bowel function during pre- and postoperative periods to decide on the optimal time for the initiation of enteral feeding.