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American Academy of Pediatrics
Article

Core Concepts: Intestinal Perfusion in the Perinatal Period

Hala Chaaban, Shadi Malaeb and Barbara S. Stonestreet
NeoReviews July 2013, 14 (7) e332-e339; DOI: https://doi.org/10.1542/neo.14-7-e332
Hala Chaaban
*Department of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City, OK.
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Shadi Malaeb
†Department of Pediatrics, Drexel University College of Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA.
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Barbara S. Stonestreet
‡Department of Pediatrics, The Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, Providence, RI.
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Abstract

The transitional physiology during the perinatal period facilitates adaptation from fetal to neonatal life and allows the gastrointestinal tract to assume essential postnatal functions. Intrinsic hemodynamic control in the developing intestines matures as a function of postnatal age. Immature vascular regulation in the newborn gastrointestinal tract is offset by an enhanced ability to extract oxygen from blood, and to some extent by increases in intestinal perfusion. Vasodilatation in the neonatal intestine is near maximal. Therefore, additional stressors particularly during the postprandial period increase the risk of mismatches in the oxygen supply to demand ratio, potentially predisposing intestinal tissue to hypoxia and ischemic injury.

  • Abbreviations:
    CF;
    control-fed
    ET-1;
    endothelin-1
    GI;
    gastrointestinal
    HF;
    hypoxemic-fed
    HNF;
    hypoxemic nonfed
    NEC;
    necrotizing enterocolitis
    NO;
    nitric oxide
    RBC;
    red blood cell
    SMA;
    superior mesenteric artery
    • Copyright © 2013 by the American Academy of Pediatrics

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    In this issue

    NeoReviews
    Vol. 14, Issue 7
    1 Jul 2013
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    Core Concepts: Intestinal Perfusion in the Perinatal Period
    Hala Chaaban, Shadi Malaeb, Barbara S. Stonestreet
    NeoReviews Jul 2013, 14 (7) e332-e339; DOI: 10.1542/neo.14-7-e332

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    Core Concepts: Intestinal Perfusion in the Perinatal Period
    Hala Chaaban, Shadi Malaeb, Barbara S. Stonestreet
    NeoReviews Jul 2013, 14 (7) e332-e339; DOI: 10.1542/neo.14-7-e332
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    • Table of Contents

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    • Article
      • Abstract
      • Learning Objectives
      • Gastrointestinal Vascular Development
      • Intestinal Blood Flow Regulation
      • Intestinal Circulation in the Perinatal Period
      • Regulation of Intestinal Perfusion in the Perinatal Period
      • Responses to Changes of Oxygen Supply or Demand
      • Response to Hypoxia
      • Response to Anemia
      • Response to Hypotension and Reduced Cardiac Output
      • Response to Feeding
      • Response to Hypothermia
      • Clinical Correlation
      • Summary
      • Footnotes
      • References
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    • Gastroesophageal Reflux Disease in Neonates: Facts and Figures
    • Fetal Heart Rate Tracing Category II: A Broad Category in Need of Stratification
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    • Gastroenterology
      • Gastroenterology
    • Fetus/Newborn Infant
      • Fetus/Newborn Infant
      • Neonatology
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