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Cerebral and splanchnic oxygenation and necrotizing enterocolitis in preterm infants

PhD ceremony:Ms T.E. (Nynke) Schat
When:July 01, 2015
Start:14:30
Supervisor:prof. dr. A.F. (Arend) Bos
Co-supervisors:drs. E.M.W. Kooi, J.B.F. Hulscher
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Cerebral and splanchnic oxygenation and necrotizing enterocolitis
in preterm infants

Necrotizing enterocolitis (NEC) is the most common and deadliest gastrointestinal disease in preterm infants. Mortality rates of NEC can be as high as 40%. Furthermore, NEC is associated with adverse neurological outcomes at school age and gastrointestinal complications in the long term, such as short bowel syndrome. Currently, we lack reliable preventive and predictive diagnostic tools to be able to minimize these devastating short- and long-term outcomes.

In this thesis we investigated the potential role of near-infrared spectroscopy (NIRS) in the diagnostic process of NEC. For this purpose we measured cerebral, liver, and intestinal oxygenation values in preterm infants suspected of having NEC and in preterm infants with an increased risk of developing NEC later on. We found that NIRS can be used to identify infants who go on to develop NEC as well as infants with established NEC who will develop a complicated course of this disease.

Additionally, we established that a blood pressure dependent cerebral blood flow might be the underlying mechanism responsible for the adverse neurological development observed in preterm infants who survived NEC. This warrants close monitoring of cerebral oxygenation and blood pressure in preterm infants with NEC.

In conclusion, NIRS might be an important method to predict and diagnose NEC timely in preterm infants, and might therefore minimize the adverse short- and long-term consequences with which NEC is associated.