title: Near-infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets.
abstract: OBJECTIVE
  A major objective of necrotizing enterocolitis (NEC) research is to devise a noninvasive method of early detection. We hypothesized that abdominal near-infrared spectroscopy (A-NIRS) readings will identify impending NEC in a large animal model.
  
  
  METHODS
  Piglets were prematurely delivered and received parenteral nutrition followed by enteral feedings. Serial A-NIRS readings were obtained for 5 days, and animals were monitored for NEC. Separately, A-NIRS readings were obtained in healthy piglets to validate the correlation of A-NIRS with splanchnic oxygen delivery.
  
  
  RESULTS
  Of 29 piglets, 3 developed NEC. Eleven piglets without NEC died prematurely. Fifteen piglets remained healthy, had normal histologic assessment of their intestines, and served as controls. Abdominal near-infrared spectroscopy readings within 12 hours of birth were significantly lower in animals that developed NEC compared with healthy littermates (4% vs 33%, P = .02). For all time-points measured, A-NIRS readings were significantly lower in the NEC group compared with controls (21% vs 55%, P < .001). Abdominal near-infrared spectroscopy readings correlated with both decreased pulse oximetry readings during apneic episodes (r = 0.96) and increased superior mesenteric artery flow in response to glucagon-like peptide 2 (r = 0.67).
  
  
  CONCLUSIONS
  Abdominal near-infrared spectroscopy is capable of detecting alterations in intestinal oxygenation and perfusion in neonatal piglets and may allow early detection of neonates at risk for NEC.
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Andre N
authors.initials: AN
authors.lastname: Gay
authors.forename: David A
authors.initials: DA
authors.lastname: Lazar
authors.forename: Barbara
authors.initials: B
authors.lastname: Stoll
authors.forename: Bindi
authors.initials: B
authors.lastname: Naik-Mathuria
authors.forename: Oren P
authors.initials: OP
authors.lastname: Mushin
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Rodriguez
authors.forename: Doug G
authors.initials: DG
authors.lastname: Burrin
authors.forename: Oluyinka O
authors.initials: OO
authors.lastname: Olutoye
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D000831:Animals, Newborn; D001707:Biopsy, Needle; D001783:Blood Flow Velocity; D004195:Disease Models, Animal; D020345:Enterocolitis, Necrotizing / Q000097:blood* / Q000473:pathology*; D005260:Female; D053767:Glucagon-Like Peptide 2 / Q000378:metabolism / Q000494:pharmacology; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000473:pathology*; D007262:Infusions, Intravenous; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000473:pathology; D008643:Mesentery / Q000098:blood supply; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000502:physiology; D011247:Pregnancy; D011897:Random Allocation; D012016:Reference Values; D019265:Spectroscopy, Near-Infrared; D013552:Swine
chemical_list: D053767:Glucagon-Like Peptide 2; D010100:Oxygen