Splanchnic haemodynamic disturbances in perinatal sepsis.
OBJECTIVE
To determine the effect of perinatal bacterial infection on the neonatal splanchnic circulation.


METHODS
76 premature infants with appropriate birth weight for gestation admitted for neonatal intensive care.


METHODS
Doppler 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.


RESULTS
Infection 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).


CONCLUSIONS
As 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.
Kempley
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ST
Neonatal Unit, Royal London Hospital, Whitechapel, St Bartholomew's and the Royal London School of Medicine and Dentistry, London, UK.
Murdoch
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D001424:Bacterial Infections / Q000209:etiology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D011247:Pregnancy; D011673:Pulsatile Flow; D013152:Splanchnic Circulation / Q000502:physiology*; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology; D018608:Ultrasonography, Doppler