Near-infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets

J Pediatr Surg. 2011 Jun;46(6):1034-40. doi: 10.1016/j.jpedsurg.2011.03.025.


Purpose: A major objective of necrotizing enterocolitis (NEC) research is to devise a noninvasive method of early detection. We hypothesized that abdominal near-infrared spectroscopy (A-NIRS) readings will identify impending NEC in a large animal model.

Methods: Piglets were prematurely delivered and received parenteral nutrition followed by enteral feedings. Serial A-NIRS readings were obtained for 5 days, and animals were monitored for NEC. Separately, A-NIRS readings were obtained in healthy piglets to validate the correlation of A-NIRS with splanchnic oxygen delivery.

Results: Of 29 piglets, 3 developed NEC. Eleven piglets without NEC died prematurely. Fifteen piglets remained healthy, had normal histologic assessment of their intestines, and served as controls. Abdominal near-infrared spectroscopy readings within 12 hours of birth were significantly lower in animals that developed NEC compared with healthy littermates (4% vs 33%, P = .02). For all time-points measured, A-NIRS readings were significantly lower in the NEC group compared with controls (21% vs 55%, P < .001). Abdominal near-infrared spectroscopy readings correlated with both decreased pulse oximetry readings during apneic episodes (r = 0.96) and increased superior mesenteric artery flow in response to glucagon-like peptide 2 (r = 0.67).

Conclusion: Abdominal near-infrared spectroscopy is capable of detecting alterations in intestinal oxygenation and perfusion in neonatal piglets and may allow early detection of neonates at risk for NEC.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Analysis of Variance
  • Animals
  • Animals, Newborn
  • Biopsy, Needle
  • Blood Flow Velocity
  • Disease Models, Animal
  • Enterocolitis, Necrotizing / blood*
  • Enterocolitis, Necrotizing / pathology*
  • Female
  • Glucagon-Like Peptide 2 / metabolism
  • Glucagon-Like Peptide 2 / pharmacology
  • Humans
  • Immunohistochemistry
  • Infant, Newborn
  • Infant, Premature, Diseases / blood*
  • Infant, Premature, Diseases / pathology*
  • Infusions, Intravenous
  • Intestines / blood supply*
  • Ischemia / pathology
  • Mesentery / blood supply
  • Oxygen / blood*
  • Oxygen Consumption / physiology
  • Pregnancy
  • Random Allocation
  • Reference Values
  • Spectroscopy, Near-Infrared*
  • Swine


  • Glucagon-Like Peptide 2
  • Oxygen