Prediction of early tolerance to enteral feeding in preterm infants by measurement of superior mesenteric artery blood flow velocity

Aims-To evaluate whether serial Doppler measurements of superior mesenteric artery (SMA) blood flow velocity after the first enteral feed could predic t early tolerance to enteral feeding in preterm infants. Methods-When clinicians decided to start enteral feeds, Doppler ultrasound blood flow velocity in the SIMA was determined before and after a test feed of 0.5 ml milk. The number of days taken for infants to tolerate full ente ral feeding (150 ml/kg/day) was recorded. Results-Fourteen infants (group 1) achieved full enteral feeding within sev en days. Thirty infants (group 2) took 8-30 days, There was no difference i n the preprandial time averaged mean velocity (TAMV) between the groups at a median age of 3 (2-30) days. In group 1, there was a significant increase in TAMV (p <0.01) above the preprandial level at 45 and 60 minutes, but th is did not occur in group 2. An increase in TAMV by more than 17% at 60 min utes has a sensitivity of 100% and a specificity of 70% for the prediction of early tolerance to enteral feeds. Conclusions-There is a significant correlation between an increase in mean SIMA blood flow velocity and early tolerance of enteral feeding. Doppler me asurements of SIMA blood flow velocity may be useful for deciding when to f eed high risk preterm infants.