Splanchnic haemodynamic disturbances in perinatal sepsis
S T Kempley, E Murdoch
Neonatal Unit, Royal
London Hospital, Whitechapel, St Bartholomew's and the Royal London
School of Medicine and Dentistry, London, UK
Correspondence to: Dr Kempley, Elizabeth Ward, Royal London Hospital, Whitechapel, London E1 1BB, UK email:
Accepted 27 March
2000
AIM
To determine the
effect of perinatal bacterial infection on the neonatal splanchnic circulation.
SUBJECTS/SETTING76
premature infants with appropriate birth weight for gestation admitted
for neonatal intensive care.
METHODSDoppler
ultrasound was used to measure blood flow velocity and pulsatility
index in the superior mesenteric artery and coeliac axis during the
first 24 hours of life. Babies were classified according to the results
of blood and surface cultures, as well as the presence or absence of
maternal prolonged membrane rupture.
RESULTSInfection
status had a significant effect on pulsatility index in both arteries,
with that in the coeliac axis being reduced from 1.27 to 0.80 in babies
with infection (p < 0.0001). Coeliac axis blood flow velocity was
significantly increased in those with infection (from 34.6 to 46.5 cm/s; p < 0.05).
CONCLUSIONAs early as
the first day of postnatal life, infected neonates show a pattern of
splanchnic hyperaemia similar to that found in adult systemic
inflammatory response syndrome.
Keywords: sepsis; splanchnic circulation; bacterial infection; infection; systemic inflammatory response syndrome
© 2000 by Archives of Disease in Childhood
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