Neonatal Portal Venous Blood Flowmetry by Doppler Ultrasound for Early Diagnosis of Ischemia in Intestinal Tract

Abstract

Purpose The aim of this article is to evaluate the utility of portal blood flow and other hemodynamic measurements for early diagnosis of ischemia that may cause necrotizing enterocolitis (NEC).

Patients and Methods We measured neonatal portal blood flow by Doppler ultrasound and performed hemodynamic examinations in 75 newborns without congenital anomalies. All newborns were followed for 1 month after birth. The average gestational period was 30.5 weeks, and the average birth weight was 1,172 g.

Results A positive correlation was observed between both body weight and the following parameters: portal vein cross-sectional area, blood flow velocity, and portal blood flow volume. A greater coefficient of correlation was observed between the portal vein cross-sectional area and weight in newborns weighing ≤ 1,500 g than in those weighing > 1,500 g. The portal vein cross-sectional area and blood flow velocity changed over time to maintain a fixed portal blood flow volume. The portal vein blood flow demonstrated a poor increase in patients with poor weight gain after birth. Seven infants demonstrated a reduction in portal vein blood flow before the development of abdominal symptoms. Both the cross-sectional area and blood flow velocity decreased over time before the onset of any symptoms of NEC.

Conclusions A significant decline in portal blood flow volume may be useful for the early diagnosis of NEC.

Keywords

necrotizing enterocolitis - Doppler ultrasound - portal venous blood flow

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