title: Use of bedside abdominal ultrasound to confirm intestinal motility in neonates with gastroschisis: A feasibility study.
abstract: BACKGROUND
  Optimal timing to begin feeds in neonates with gastroschisis remains unclear. We examined if bedside abdominal ultrasound for intestinal motility is a feasible tool to detect return of bowel function in neonates with gastroschisis.
  
  
  METHODS
  Neonates born with uncomplicated gastroschisis who underwent closure received daily ultrasound exams. Full motility was defined as peristalsis seen in all quadrants. Average length of time between abdominal wall closure and start of enteral feeds, full ultrasound motility, and clinical characteristics was compared using Student's t-tests.
  
  
  RESULTS
  Seventeen patients were enrolled. No differences were found between motility on ultrasound and bowel movements, gastric residuals, or nonbilious residuals. Mean time to enteral feeds (11.82days) was significantly delayed compared to documentation of full motility on ultrasound (8.94days; p=0.012), consistent bowel movements (8.41days; p=0.006), low gastric residuals (9.47days; p<0.001), and nonbilious residuals (9.18days; p<0.001). In the single subject in which feeds were started before full motility was seen on ultrasound, feeds were subsequently discontinued because of emesis.
  
  
  CONCLUSIONS
  Bedside abdominal ultrasound provides real-time evidence regarding intestinal motility and is a feasible tool to detect return of bowel function in neonates with gastroschisis. Future studies are needed to determine if abdominal ultrasound can shorten time to start of enteral feeds.
  
  
  METHODS
  III (diagnosis: nonconsecutive study).
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA. Electronic address: lgurien@gmail.com.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Gurien
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Deidre L
authors.initials: DL
authors.lastname: Wyrick
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Melvin S
authors.initials: MS
authors.lastname: Dassinger
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Burford
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Mehl
authors.affiliation: Department of Biostatistics, Arkansas Children's Hospital Research Institute, Little Rock, AR, USA.
authors.forename: Marie E
authors.initials: ME
authors.lastname: Saylors
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Smith
mesh_terms: D004750:Enteral Nutrition; D005240:Feasibility Studies; D005260:Female; D005769:Gastrointestinal Motility; D020139:Gastroschisis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D000067716:Point-of-Care Testing; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography / Q000295:instrumentation
keywords: Feasibility study; Gastroschisis; Intestinal motility; Neonates; Ultrasound