title: Intestinal hydrogen and nitric oxide gases in preterm infants--effects of antibiotic therapy.
abstract: OBJECTIVE
  Measurements of hydrogen (H(2)) and nitric oxide (NO) levels in intestinal gas have recently been shown to be useful to monitor bacterial colonization in healthy term newborn infants. The significance of preterm birth and antibiotic therapy for intestinal gas production is not known and was the subject of this study.
  
  
  METHODS
  A minimally invasive tonometric technique was used for repeated measurements (44 samples) of luminal colonic H(2) and NO in 23 preterm infants with gestational age 27-35 weeks, birth weight 1,170-2,996 g and postnatal age 2-31 days.
  
  
  RESULTS
  The measuring procedure was well tolerated in all infants. Intestinal H(2) was 300 (4-1,990) ppm and NO was 34 (11-82) ppb. Intestinal H(2) and NO increased during the first week (p < 0.05) to average levels that in the case of H(2), exceeded those of healthy, term infants. In preterm infants treated with antibiotics (n = 12), H(2) and NO levels were significantly lower than in those without such therapy (p < 0.05).
  
  
  CONCLUSIONS
  These observations suggest that intestinal measurements of H(2) and NO may be used to monitor birth-related bacterial colonization in relation to postnatal age, maturation and antibiotic therapy. In preterm infants, gaseous distension of the gut is common and may signal bacterial overgrowth. The potential role of intestinal gas measurements as a diagnostic tool for intestinal disorders remains to be clarified.
authors.affiliation: Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. tanja.sobko@ki.se
authors.forename: Tanja
authors.initials: T
authors.lastname: Sobko
authors.forename: Kristina
authors.initials: K
authors.lastname: Elfström
authors.forename: Lars
authors.initials: L
authors.lastname: Navér
authors.forename: Jon O
authors.initials: JO
authors.lastname: Lundberg
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D018407:Bacterial Physiological Phenomena; D003106:Colon / Q000378:metabolism* / Q000382:microbiology*; D005260:Female; D005740:Gases / Q000378:metabolism; D005865:Gestational Age; D006801:Humans; D006859:Hydrogen / Q000378:metabolism*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D005740:Gases; D009569:Nitric Oxide; D006859:Hydrogen