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Evaluation of Superior Mesenteric Artery (SMA) and Celiac Artery (CA) Blood Flow Pattern in Preterm Infants and Factors Influencing the Blood Flow
Nitin Ramdas Unde, Khaled Mahmoud El-Atawi, Mahmoud Saleh Elhalik and Arif Moinuddin Faquih
Objective: To evaluate the blood flow velocity (BFV) in superior mesenteric artery (SMA) and celiac artery (CA) in first 2 days of life in preterm (less than 32 week and less than 1 kg) and to study the influence of various factors on the blood flow velocities in the same population.
Methods: 50 preterm less than 32 week with birth weight less than 1 kg was included in the prospective observation study. Assessment of SMA and CA blood flow velocities (PSV: peak systolic velocity, EDV: end diastolic velocity, TAV: time average velocity) was done twice at 24 h (20-30) and at 48 h (40-54). Blood flow indices (resistive index; RI, pulsatile index; PI) was calculated using the formula. Simultaneously data for various factors influencing the blood flow in SMA and CA was collected in the similar population.
Results: SMA BFV increases from 24 h after birth and continue to rise thereafter in first 2 days. Significant increase in SMA EDV (6.77 ± 2.38 vs. 8.74 ± 4.42) and SMA PSV (37.16 ± 10.64 vs. 42.72 ± 14.66) was noted postnatally. Increase in SMA TAV was also observed. CA BFV showed negative trend from 24 h after birth with reduction of all velocities (PSV, EDV and TAV). CA TAV showed significant reduction at 48 h of age compared to 24 h (28.22 ± 9.81 vs. 25.00 ± 8.07). Significant PDA was associated with attenuated BFV in both the SMA and CA on both the occasions. Other factors associated with adverse blood flow velocities were blood transfusion and anemia. Trophic feeding was associated with increase blood flow velocities in both SMA and CA.
Conclusion: Postnatally increase in SMA BFV was noted in first 2 days of life indicating improved intestinal perfusion and opposite trend in CA BFV. Significant PDA was associated with abnormal blood flow velocities in both SMA and CA.