Högberg N1*, Per-Ola Carlsson2,4, Hillered L3, Stenbäck A1, Larsson A4 and Lilja HE1
¹Department of Women´s and Children´s Health, Uppsala University, Sweden
²Department of Medical Cell Biology, Uppsala University, Sweden
³Department of Neuroscience, Uppsala University, Sweden
4Department of Medical Sciences, Uppsala University, Sweden
Purpose: Necrotizing enterocolitis (NEC) is highly associated with prematurity, and is characterized by bowel necrosis and multiple organ failure. There is a strong need for improved diagnostic methods to reduce the significant morbidity and mortality associated with NEC. The aim of this single center prospective study was to investigate the possibility of detecting early signs of NEC, by using rectal intraluminal microdialysis and plasma intestinal fatty acid binding protein (I-FABP) in preterm infants, admitted to a level III neonatal intensive care unit.Methods: The study was performed on extremely preterm infants with a gestational age of less than 28 weeks. During a 4-week period after birth, rectal intraluminal microdialysate levels of glucose, lactate, pyruvate and glycerol were measured, and plasma was collected for I-FABP analysis. Infants not developing NEC served as controls.Results: Microdialysis revealed signs of intestinal hypoxic or ischemic damage and cell membrane degradation, with a marked increase of both intraluminal glycerol and plasma I-FABP in infants developing NEC, as well as in infants suffering from other complications. The microdialysate levels of glucose, lactate and pyruvate were too low to be evaluated in this setting. All infants tolerated the microdialysis well without any complications.Conclusion: Elevated levels of intraluminal glycerol and plasma I-FABP suggests mucosal cell membrane degradation and hypoxic or ischemic damage in preterm infants developing NEC, as well as in preterm infants suffering from other complications such as volvulus, sepsis or respiratory distress. However, it was not possible to predict development of NEC before clinical diagnosis using these markers.
Necrotizing; Enterocolitis; Intraluminal; Microdialysis; Glycerol; I-FABP
Hogberg N, Per-Ola Carlsson, Hillered L, Stenback A, Larsson A, Lilja HE. Intestinal Intraluminal Glycerol and Plasma I-FABP Levels In Preterm Infants with Necrotizing Enterocolitis. Clin Surg. 2016; 1: 1085.