title: A Doppler velocimetry evaluation of intestinal blood flow characteristics in neonates receiving intravenous immunoglobulin therapy: a prospective observational study.
abstract: OBJECTIVE
  To evaluate intestinal blood flow changes after intravenous immunoglobulin (IVIg) infusion among neonates with Rh isoimmunization and alloimmune thrombocytopenia.
  
  
  METHODS
  This prospective observational study was conducted in level III NICU from July 2011 through August 2012. Thirty three consecutive instances (30 neonates) of IVIg treatment (1 g/kg) were studied. Celiac (CA) and superior mesenteric artery (SMA) doppler evaluations were performed immediately prior (baseline), immediately after and 12 to18 h following IVIg infusion. Peak systolic velocity, end diastolic velocity, time-averaged mean velocity, pulsatility index, resistive index and systolic/diastolic ratio were measured. The doppler indices measured immediately after and 12 to 18 h after IVIg infusion were compared with the baseline values.
  
  
  RESULTS
  The mean gestation and birth weight of the cohort were 36 ± 2 wk and 2597 ± 563 g respectively. Doppler flow variables measured immediately after and 12 to 18 h after IVIg were comparable to baseline values, in both the arteries. However, systolic/diastolic ratio in SMA immediately post-IVIg was lower than baseline, [median (IQR): 5 (3, 9) vs. 7 (4, 14), respectively; p=0.02]. None of the study infants developed feed intolerance or necrotizing enterocolitis (NEC).
  
  
  CONCLUSIONS
  There was no significant change in the celiac and SMA blood flows following IVIg therapy in neonates with Rh isoimmunization and alloimmune thrombocytopenia.
authors.affiliation: Newborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Louis
authors.forename: Sandeep
authors.initials: S
authors.lastname: Patil
authors.forename: Shiv Sajan
authors.initials: SS
authors.lastname: Saini
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
mesh_terms: D002445:Celiac Artery / Q000502:physiology*; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects; D007231:Infant, Newborn; D007422:Intestines / Q000098:blood supply*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000502:physiology*; D012039:Regional Blood Flow; D012203:Rh Isoimmunization / Q000503:physiopathology; D012212:Rheology / Q000379:methods*; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors