0018
THE
CORRELATION BETWEEN GASTROINTESTIONAL AND RENAL HEMODYNAMIC CHANGES IN
ASPHYXIATED NEONATES Liu J, Cao HY Objective: Newborn infants with asphyxia are believed to be
at increased risk of having necrotizing enterocolitis and renal dysfunction
because of a hemodynamic disturbance in the splanchnic and renal
circulation. The purpose of this study was to correlate the severity of the
gastrointestinal tract and the kidneys that are particularly . Methods: Thirty term neonates with both blood pH<7.30
and a 1-minute Apgar score≤6 and
twenty-five healthy newborn infants were enrolled in this study. All
asphyxiated neonates were studied with in 24 hours. We used an
Ultramark-9 color and duplex doppler unite with a 6.0 MHz sector probe to
insonate the superior mesenteric artery (SMA) and renal artery (RA) at an
angle as close to zero as possible to measure their blood flow velocity
profiles. For each vessels the peak systolic flow velocity (PSFV,cm/s),
end-diastolic flow velocity (EDFV,cm/s), time-averaged mean velocity
(TAMV,cm/s) were determined. In addition, resistance index (RI) and
pulsatility index (PI) were determined automatically by the built-in
software of the system . Results: (1)The hemodynamic parameter change of SMA in
neonates with birth asphyxia and health controls was respectively: RSFV (55.0�15.4)cm/s vs (92.1�14.1) cm/s, EDFV(5.6�5.1) cm/s vs
(26.7�5.7) cm/s, TAMV (26.4�9.7) cm/s vs (41.0�6.2) cm/s, PI (1.97�0.38) vs (1.67�0.22), RI (0.89�0.09) vs (0.75�0.05) (p<0.01). (2)The hemodynamic parameter
changes of RA in neonates with birth asphyxia and health controls was
respectively: PSFV(24.6�7.1) cm/s vs
(47.5�9.5) cm/s, EDFV (4.1�1.3) cm/s vs (14.8�3.4) cm/s, TAMV (9.6�3.9) cm/s vs (27.4�6.4 ) cm/s, PI (2.12�0.36) vs (0.82�0.04), RI (1.19�0.11) vs (0.68�0.04)
(p<0.01). (3)The reduced degree of EDFV were 70％ in kidneys and 80％ in SMA respectively,six of
SMA had absent diastolic flow in the SMA. (4)In the study, all the babies were
restudied every 24 hours until the profile returned to normal,the
persistent abnormal SMA doppler findings in one-third of neonates at <7
days and two-third at >7days and even some of them until after 12～14 days of age, while the RA abnormal doppler findings
returned to normal within 7 days. Conclusion: (1)The gastrointestinal tract is believed to be
particularly vulnerable to hemodynamic perturbation as a result of
perinatal hypoxemia. This could result in bowel ischemia as an antecedent
of necrotizing enterocolitis. (2)Although both kidney and intestinal tract
are non-living organs, the reduced degree of blood perfusion of kidneys was
less than that of intestinal tract ,which will help to preserve the renal
function.
Department of Pediatrics, Beijing Yanhua Hospital,
Beijing, China