{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:54:44Z","timestamp":1787320484518,"version":"build-2736575974"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>\n                    The gut is a relatively silent organ\n                    <jats:italic>in utero<\/jats:italic>\n                    but takes on a major role after birth for the absorption and digestion of feed for adequate nutrition and growth. The neonatal circulation undergoes a transition period after birth, and gut perfusion increases rapidly to satisfy the oxygen demand and consumption. If this process is compromised at any stage, preterm and fetal growth restricted infants are at particular risk of gut tissue injury secondary to hypoxia, leading to necrotizing enterocolitis. Feeding can also be a challenge in these high-risk groups due to gut dysmotility. Superior mesenteric artery (SMA) Doppler is a safe, bedside investigation that could rapidly aid clinicians with feeding strategies and in monitoring high-risk infants. This article aims to establish normal patterns of gut blood flow velocity in neonates using SMA Doppler and reviews how it might be used clinically in pathologic states.\n                  <\/jats:p>","DOI":"10.3389\/fped.2023.1154611","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T09:07:46Z","timestamp":1690967266000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Measuring gut perfusion and blood flow in neonates using ultrasound Doppler of the superior mesenteric artery: a narrative review"],"prefix":"10.3389","volume":"11","author":[{"given":"C.","family":"Murphy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Baskind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Aladangady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"F293","DOI":"10.1136\/adc.2003.027367","article-title":"Minimal enteral feeding, fetal blood flow pulsatility, and postnatal intestinal permeability in preterm infants with intrauterine growth retardation","volume":"89","author":"van Elburg","year":"2004","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B2","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/B978-0-323-40232-3.00086-8","article-title":"Chapter 86\u2014anatomy and physiology of the mesenteric circulation","volume-title":"Shackelford's surgery of the alimentary tract, 2 volume set (eighth edition)","author":"Zimmerman","year":"2019"},{"key":"B3","doi-asserted-by":"publisher","first-page":"769","DOI":"10.7863\/jum.1998.17.12.769","article-title":"Superior mesenteric artery blood flow velocimetry: cross-sectional Doppler sonographic study in normal fetuses","volume":"17","author":"Achiron","year":"1998","journal-title":"J Ultrasound Med"},{"key":"B4","first-page":"181","article-title":"Fetal and neonatal intestinal circulations","volume-title":"Physiology of the intestinal circulation","author":"Edelstone","year":"1984"},{"key":"B5","first-page":"3","article-title":"Transitions in the life of the gut at birth","author":"Sangild","year":"2001"},{"key":"B6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1111\/j.1471-0528.2006.01118.x","article-title":"EPICure: facts and figures: why preterm labour should be treated","volume":"113","author":"Costeloe","year":"2006","journal-title":"BJOG"},{"key":"B7","doi-asserted-by":"publisher","first-page":"F182","DOI":"10.1136\/archdischild-2017-313880","article-title":"Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review","volume":"103","author":"Battersby","year":"2018","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B8","first-page":"145","article-title":"Mapping the new world of necrotizing enterocolitis (NEC): review and opinion","volume":"2","author":"Gordon","year":"2012","journal-title":"EJ Neonatol Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e298","DOI":"10.1542\/peds.2011-2022","article-title":"Incidence and timing of presentation of necrotizing enterocolitis in preterm infants","volume":"129","author":"Yee","year":"2012","journal-title":"Pediatrics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3109\/15513815.2010.483874","article-title":"Can we cut the incidence of necrotizing enterocolitis in half\u2014today?","volume":"29","author":"Christensen","year":"2010","journal-title":"Fetal Pediatr Pathol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jpeds.2006.05.011","article-title":"The premature infants in need of transfusion (PINT) study: a randomized, controlled trial of a restrictive (LOW) versus liberal (HIGH) transfusion threshold for extremely low birth weight infants","volume":"149","author":"Kirpalani","year":"2006","journal-title":"J Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1038\/sj.jp.7211551","article-title":"Factors that influence mesenteric artery blood flow velocity in newborn preterm infants","volume":"26","author":"Havranek","year":"2006","journal-title":"J Perinatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1053\/j.semperi.2012.04.011","article-title":"Transfusion-related acute gut injury: feeding, flora, flow, and barrier defense","volume":"36","author":"La Gamma","year":"2012","journal-title":"Semin Perinatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/vox.12436","article-title":"Blood transfusion in preterm infants improves intestinal tissue oxygenation without alteration in blood flow","volume":"111","author":"Banerjee","year":"2016","journal-title":"Vox Sang"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1770","DOI":"10.3109\/14767058.2014.971746","article-title":"Packed red blood cell transfusion (PRBC) attenuates intestinal blood flow responses to feedings in pre-term neonates with normalization at 24\u2005h","volume":"28","author":"Pitzele","year":"2015","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B16","author":"Gale","year":"2019"},{"key":"B17","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/0741-5214(86)90117-5","article-title":"Use of hemodynamic parameters in the diagnosis of mesenteric insufficiency","volume":"3","author":"Nicholls","year":"1986","journal-title":"J Vasc Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/0741-5214(93)90011-A","article-title":"Mesenteric duplex scanning: a blinded prospective study","volume":"17","author":"Moneta","year":"1993","journal-title":"J Vasc Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1148\/radiology.211.2.r99ma27405","article-title":"Splanchnic arterial stenosis or occlusion: diagnosis at Doppler US","volume":"211","author":"Lim","year":"1999","journal-title":"Radiology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/S0741-5214(98)60010-0","article-title":"Mesenteric and celiac duplex scanning: a validation study","volume":"27","author":"Zwolak","year":"1998","journal-title":"J Vasc Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.jvs.2011.08.052","article-title":"Mesenteric\/celiac duplex ultrasound interpretation criteria revisited","volume":"55","author":"AbuRahma","year":"2012","journal-title":"J Vasc Surg"},{"key":"B22","first-page":"197","article-title":"Superior mesenteric blood flow during digestion in man","volume":"141","author":"Norryd","year":"1975","journal-title":"Acta Chir Scand"},{"key":"B23","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1177\/1531003506291885","article-title":"Mesenteric duplex scanning","volume":"18","author":"Mitchell","year":"2006","journal-title":"Perspect Vasc Surg Endovasc Ther"},{"key":"B24","doi-asserted-by":"publisher","first-page":"71","DOI":"10.4081\/pmc.2017.160","article-title":"Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications","volume":"39","author":"Bozzetti","year":"2017","journal-title":"Pediatr Med Chir"},{"key":"B25","doi-asserted-by":"publisher","first-page":"F42","DOI":"10.1136\/fn.85.1.F42","article-title":"Prediction of early tolerance to enteral feeding in preterm infants by measurement of superior mesenteric artery blood flow velocity","volume":"85","author":"Fang","year":"2001","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B26","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1097\/00005176-199207000-00002","article-title":"Doppler assessment of human neonatal gut blood flow velocities: postnatal adaptation and response to feeds","volume":"15","author":"Coombs","year":"1992","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e000333","DOI":"10.1136\/bmjpo-2018-000333","article-title":"Arterial flow patterns in healthy transitioning near-term neonates","volume":"3","author":"Stritzke","year":"2019","journal-title":"BMJ Paediatr Open"},{"key":"B28","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1203\/00006450-199409000-00011","article-title":"Mesenteric blood flow velocity and its relation to circulatory adaptation during the first week of life in healthy term infants","volume":"36","author":"Martinussen","year":"1994","journal-title":"Pediatr Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3233\/NPM-14814035","article-title":"Quiescent variability of cerebral, renal, and splanchnic regional tissue oxygenation in very low birth weight neonates","volume":"7","author":"Mintzer","year":"2014","journal-title":"J Neonatal-Perinat Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1148\/radiology.174.1.2403678","article-title":"Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates","volume":"174","author":"Van Bel","year":"1990","journal-title":"Radiology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/0378-3782(94)90147-3","article-title":"Early postnatal cerebral Doppler changes in relation to birth weight","volume":"37","author":"Cheung","year":"1994","journal-title":"Early Hum Dev"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.7863\/jum.2012.31.9.1381","article-title":"Doppler middle cerebral artery peak systolic velocity for diagnosis of neonatal anemia","volume":"31","author":"Weissman","year":"2012","journal-title":"J Ultrasound Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1542\/peds.2006-0272","article-title":"Doppler flow velocimetry in the superior mesenteric artery on the first day of life in preterm infants and the risk of neonatal necrotizing enterocolitis","volume":"118","author":"Murdoch","year":"2006","journal-title":"Pediatrics"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.3109\/14767058.2013.799649","article-title":"Superior mesenteric artery Doppler is poor at predicting feed intolerance and NEC in preterm small for gestational age neonates","volume":"26","author":"Louis","year":"2013","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"091306","DOI":"10.1117\/1.JBO.21.9.091306","article-title":"Review of splanchnic oximetry in clinical medicine","volume":"21","author":"Bailey","year":"2016","journal-title":"J Biomed Opt"},{"key":"B36","doi-asserted-by":"publisher","first-page":"F45","DOI":"10.1136\/fn.71.1.F45","article-title":"Effects of red cell transfusion on cardiac output and blood flow velocities in cerebral and gastrointestinal arteries in premature infants","volume":"71","author":"Nelle","year":"1994","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B37","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1111\/vox.12436","article-title":"Blood transfusion in preterm infants improves intestinal tissue oxygenation without alteration in blood flow","volume":"111","author":"Banerjee","year":"2016","journal-title":"Vox Sang"},{"key":"B38","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/j.earlhumdev.2013.07.006","article-title":"Feeding issues in IUGR preterm infants","volume":"89","author":"Bozzetti","year":"2013","journal-title":"Early Hum Dev"},{"key":"B39","doi-asserted-by":"publisher","first-page":"288.e1","DOI":"10.1016\/j.ajog.2014.05.008","article-title":"The role of brain sparing in the prediction of adverse outcomes in intrauterine growth restriction: results of the multicenter PORTO study","volume":"211","author":"Flood","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2298\/SARH1602069B","article-title":"Doppler changes as the earliest parameter in fetal surveillance to detect fetal compromise in intrauterine growth-restricted fetuses","volume":"144","author":"Bansal","year":"2016","journal-title":"Srp Arh Celok Lek"},{"key":"B41","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1097\/01.AOG.0000253215.79121.75","article-title":"Predictors of neonatal outcome in early-onset placental dysfunction","volume":"109","author":"Baschat","year":"2007","journal-title":"Obstet Gynecol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"4037","DOI":"10.3109\/14767058.2016.1154525","article-title":"Intrauterine growth restriction\u2014part 2","volume":"29","author":"Sharma","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1136\/archdischild-2013-304393","article-title":"Feeding infants below 29 weeks\u2019 gestation with abnormal antenatal Doppler: analysis from a randomised trial","volume":"99","author":"Kempley","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B44","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1001\/jama.2016.1204","article-title":"Association of red blood cell transfusion, anemia, and necrotizing enterocolitis in very low-birth-weight infants","volume":"315","author":"Patel","year":"2016","journal-title":"JAMA"},{"key":"B45","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1007\/s002470050621","article-title":"Intestinal blood-flow velocity in uncomplicated preterm infants during the early neonatal period","volume":"29","author":"Maruyama","year":"1999","journal-title":"Pediatr Radiol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1111\/trf.13434","article-title":"Effect of blood transfusion on intestinal blood flow and oxygenation in extremely preterm infants during first week of life","volume":"56","author":"Banerjee","year":"2016","journal-title":"Transfusion"},{"key":"B47","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1055\/s-0028-1090595","article-title":"Blood transfusion alters the superior mesenteric artery blood flow velocity response to feeding in premature infants","volume":"26","author":"Krimmel","year":"2009","journal-title":"Am J Perinatol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"F139","DOI":"10.1136\/fn.83.2.F139","article-title":"Splanchnic haemodynamic disturbances in perinatal sepsis","volume":"83","author":"Kempley","year":"2000","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B49","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s00247-010-1806-4","article-title":"Bowel sonography in sepsis with pathological correlation: an experimental study","volume":"41","author":"Kim","year":"2011","journal-title":"Pediatr Radiol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1007\/s00247-004-1285-6","article-title":"Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants","volume":"34","author":"Robel-Tillig","year":"2004","journal-title":"Pediatr Radiol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"F49","DOI":"10.1136\/fn.79.1.F49","article-title":"Effect of feed interval and feed type on splanchnic haemodynamics","volume":"79","author":"Lane","year":"1998","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"B52","doi-asserted-by":"publisher","first-page":"e0212256","DOI":"10.1371\/journal.pone.0212256","article-title":"Natural evolution of ductus arteriosus with noninterventional conservative management in extremely preterm infants born at 23-28 weeks of gestation","volume":"14","author":"Sung","year":"2019","journal-title":"PLoS One"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1017\/S1047951115001869","article-title":"Surgical ligation of patent ductus arteriosus in premature infants: trends and practice variation","volume":"26","author":"Weinberg","year":"2016","journal-title":"Cardiol Young"},{"key":"B54","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1056\/NEJM200009073431009","article-title":"Ibuprofen and patent ductus arteriosus","volume":"343","author":"Clyman","year":"2000","journal-title":"Mass Medical Soc"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/peds.2020-1209","article-title":"Patent ductus arteriosus of the preterm infant","volume":"146","author":"Hamrick","year":"2020","journal-title":"Pediatrics"},{"key":"B56","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.jpeds.2019.08.057","article-title":"Effects of patent ductus arteriosus on organ blood flow in infants born very preterm: a prospective study with serial echocardiography","volume":"216","author":"Hsu","year":"2020","journal-title":"J Pediatr"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1056\/NEJM198906083202302","article-title":"A randomized, controlled trial of very early prophylactic ligation of the ductus arteriosus in babies who weighed 1000\u2005g or less at birth","volume":"320","author":"Cassady","year":"1989","journal-title":"N Engl J Med"},{"key":"B58","doi-asserted-by":"publisher","first-page":"CD010061","DOI":"10.1002\/14651858.CD010061.pub3","article-title":"Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants","volume":"4","author":"Ohlsson","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"B59","doi-asserted-by":"publisher","first-page":"590578","DOI":"10.3389\/fped.2020.590578","article-title":"Management of patent ductus arteriosus in premature infants in 2020","volume":"8","author":"Parkerson","year":"2021","journal-title":"Front Pediatr"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1038\/s41372-019-0518-3","article-title":"Pharmacological closure of the patent ductus arteriosus: when treatment still makes sense","volume":"39","author":"Gillam-Krakauer","year":"2019","journal-title":"J Perinatol"},{"key":"B61","doi-asserted-by":"publisher","first-page":"e1262","DOI":"10.1542\/peds.2008-2045","article-title":"Effects of a patent ductus arteriosus on postprandial mesenteric perfusion in premature baboons","volume":"122","author":"McCurnin","year":"2008","journal-title":"Pediatrics"},{"key":"B62","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/j.jpeds.2013.11.002","article-title":"Superior mesenteric artery blood flow velocities following medical treatment of a patent ductus arteriosus","volume":"164","author":"Yanowitz","year":"2014","journal-title":"J Pediatr"},{"key":"B63","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1136\/adc.65.10_Spec_No.1067","article-title":"Gut blood flow velocities in the newborn: effects of patent ductus arteriosus and parenteral indomethacin","volume":"65","author":"Coombs","year":"1990","journal-title":"Arch Dis Child"},{"key":"B64","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1038\/jp.2013.3","article-title":"Correlation of abdominal rSO2 with superior mesenteric artery velocities in preterm infants","volume":"33","author":"Gillam-Krakauer","year":"2013","journal-title":"J Perinatol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1154611\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T09:07:53Z","timestamp":1690967273000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1154611\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,2]]},"references-count":64,"alternative-id":["10.3389\/fped.2023.1154611"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1154611","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,2]]},"article-number":"1154611"}}