THE GUT BLOOD FLOW, MOTILITY AND GASTRIC
MYOELECTRICAL ACTIVITY IN NEONATES WITH BIRTH ASPHYXIA
Sun M, Mao Z-Q, Zhang H and Han Y-K
Pediatric Department of
Second Clinical College, China Medical University, Shenyang, China
Objective: To obtain better insights into the
effects of birth asphyxia on gastrointestinal function of neonates, we
conducted a series of studies about GI tract on a cohort of newborns after
birth asphyxia.
Methods: (1) The duplex pulse Doppler ultrasound was used in 22 asphyxiated
neonates and 30 controls to evaluate the dynamic change of gut blood
flow. (2) 24 hours double pH monitoring of esophagus and stomach were
performed in 35 patients and 17 controls to character their motor activity.
(3) Cutaneous electrogastrography (EEG) were measured in 50 patients and 20
controls to investigate their gastric electricity. All the data were
computed and analyzed by their software.
Results: (1) The blood flow velocity and flow volume of superior mesenteric artery
(SMA) and coeliac artery (CA) were decreased significantly in asphyxiated
infants than the controls on the first, third day after birth. (2) By the
24 hours esophageal pH monitoring it was noted that the variables of acid
reflex in asphyxia group were all dramatically higher than those of
controls. These abnormal variables were met the diagnostic criterion of
pathologic gastroesophageal reflux (GER). (3) It can be noted in the EEG
analysis that asphyxia infants presented a higher percentage of gastric
arrhythmia than normal controls: The abnormal rhythm of severe asphyxiated
infants can be corrected by prokinetic agent.
Conclusions: Following
the birth asphyxia there is an intestinal hypoperfusion period in the
patients. The acid GER of asphyxia infants were significantly severer than
that of controls. The abnormal motility may be caused by the disturbed
gastrointestinal electrical rhythm.