Predicting intestinal recovery after necrotizing enterocolitis in preterm infants

Sara J Kuik*, Willemien S Kalteren, Mirthe J Mebius, Arend F Bos, Jan B F Hulscher, Elisabeth M W Kooi

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Background: Intestinal recovery after NEC is difficult to predict in individuals. We evaluated whether several biomarkers predict intestinal recovery after NEC in preterm infants. Methods: We measured intestinal tissue oxygen saturation (rintSO2) and collected urinary intestinal-fatty acid binding protein (I-FABPu) levels 0–24 h and 24–48 h after NEC onset, and before and after the first re-feed. We assessed intestinal recovery in two ways: time to full enteral feeding (FEFt; below or equal/above group’s median) and development of post-NEC complications (recurrent NEC/post-NEC stricture). We determined whether the rintSO2, its range, and I-FABPu differed between groups. Results: We included 27 preterm infants who survived NEC (Bell’s stage ≥ 2). Median FEFt was 14 [IQR: 12–23] days. Biomarkers only predicted intestinal recovery after the first re-feed. Mean rintSO2 ≥ 53% combined with mean rintSO2range ≥ 50% predicted FEFt < 14 days with OR 16.7 (CI: 2.3–122.2). The rintSO2range was smaller (33% vs. 51%, p < 0.01) and I-FABPu was higher (92.4 vs. 25.5 ng/mL, p = 0.03) in case of post-NEC stricture, but not different in case of recurrent NEC, compared with infants without complications. Conclusion: The rintSO2, its range, and I-FABPu after the first re-feed after NEC predicted intestinal recovery. These biomarkers have potential value in individualizing feeding regimens after NEC.

Original languageEnglish
Pages (from-to)903-909
Number of pages7
JournalPediatric Research
Volume87
Issue number5
Early online date24-Oct-2019
DOIs
Publication statusPublished - Apr-2020

Keywords

  • NEAR-INFRARED SPECTROSCOPY
  • SUPERIOR MESENTERIC-ARTERY
  • ACID-BINDING PROTEIN
  • SPLANCHNIC OXYGENATION
  • INTERNATIONAL SURVEY
  • TISSUE OXYGENATION
  • ISCHEMIA
  • RISK
  • MANAGEMENT
  • DIAGNOSIS

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