Intraperitoneal microdialysis in the postoperative surveillance after surgery for necrotizing enterocolitis: a preliminary report

• Published in: Journal of pediatric surgery Vol. 46; no. 2; pp. 352 - 356
• Main Authors: Pedersen, Mark E, Dahl, Marianne, Qvist, Niels
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2011
• Subjects: Abdominal Cavity; Enterocolitis, Necrotizing - metabolism; Enterocolitis, Necrotizing - surgery; Extracellular Fluid - chemistry; Glucose - analysis; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - metabolism; Infant, Premature, Diseases - surgery; Intraperitoneal microdialysis; Lactate/pyruvate ratio; Lactates - analysis; Microdialysis - adverse effects; Microdialysis - methods; Monitoring, Physiologic - methods; Necrotizing enterocolitis; Pediatrics; Peritoneal Dialysis - adverse effects; Peritoneal Dialysis - methods; Pilot Projects; Postoperative Care - methods; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Pyruvates - analysis; Surgery; Lactate/pyruvate ratio; Necrotizing enterocolitis; Intraperitoneal microdialysis
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2010.11.015

Abstract Background/Purpose The aim of the present pilot study was to evaluate the safety and clinical application of intraperitoneal microdialysis (MD) in preterm infants operated on for necrotizing enterocolitis (NEC). Methods Fourteen infants underwent MD. Two were excluded from analysis: 1 because of catheter malfunction and 1 because of fatal outcome immediately after surgery. The median MD time was 122 hours. Samples were collected every 4 hours, and the concentration of glucose, lactate, pyruvate, and glycerol was measured. Results Three infants were reoperated on: 2 because of recurrent NEC and 1 because of ileal stenosis. In the 2 cases with recurrent NEC, changes in MD variables were found. Another had a prolonged postoperative period owing to diffuse fecal peritonitis. The values of MD normalized along with the return of bowel function. In 8 infants, the postoperative course was uncomplicated. The results of peritoneal MD in patients with complications were significantly different from those with an uncomplicated course (lactate/pyruvate ratio and glucose concentration). Conclusion Peritoneal MD is a safe procedure and an applicable method in surveillance of the metabolic and inflammatory changes in the peritoneal cavity after surgery for NEC. Larger series are needed to evaluate the clinical significance and use of this method.