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Faecal calprotectin concentrations in neonates with CHD: pilot study

Published online by Cambridge University Press:  03 April 2020

Graeme O’Connor Open the ORCID record for Graeme O’Connor [Opens in a new window] ,
Katherine L. Brown  and
Andrew M. Taylor
Graeme O’Connor*
Affiliation:
Heart and Lung Department, Cardiothoracic Intensive Care Unit, Great Ormond Street Children’s Hospital, London, UK Population, Policy and Practice Research Department, Nutrition Unit, Institute of Child Health and University College London, London, UK
Katherine L. Brown
Affiliation:
Heart and Lung Department, Cardiothoracic Intensive Care Unit, Great Ormond Street Children’s Hospital, London, UK Population, Policy and Practice Research Department, Nutrition Unit, Institute of Child Health and University College London, London, UK
Andrew M. Taylor
Affiliation:
Heart and Lung Department, Cardiothoracic Intensive Care Unit, Great Ormond Street Children’s Hospital, London, UK Population, Policy and Practice Research Department, Nutrition Unit, Institute of Child Health and University College London, London, UK Centre for Translational Cardiovascular Imaging, Cardiovascular Imaging, Institute of Child Health and University College London, London, UK
*
Author for correspondence: G. O’Connor, Great Ormond Street Children’s Hospital, Great Ormond Street, LondonWC1N 3JH, UK. Tel: +4402074059200; Fax: +4478138515. E-mail: graeme.oconnor@nhs.net
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Abstract

Neonates with CHD are at increased risk of developing necrotising enterocolitis due to mesenteric hypoperfusion. Necrotising enterocolitis results in repeated feed interruptions contributing to poor growth during the early post-operative phase. Poor weight gain and longer hospital stay are risk factors for death in neonates with CHD. Abdominal radiography is used as a diagnostic tool for necrotising enterocolitis; however, its utility is limited in the early stages of necrotising enterocolitis when pneumatosis intestinalis is absent. Calprotectin is a neutrophil activation biomarker, and elevated levels are evident in inflammatory diseases such as necrotising enterocolitis. The aim of this study was to determine whether there is a correlation between faecal calprotectin concentration and gut inflammation in neonates with CHD. This prospective single-centre study recruited newly diagnosed term patients with duct-dependent CHD between March 2018 and March 2019. Faecal calprotectin concentrations were measured in post-surgical patients using enzyme-linked immunosorbent assay methods. A total of 30 patients were included in the analysis. Calprotectin concentration for patients who developed necrotising enterocolitis was 3528 µg/g compared with 390 µg/g without, compared with 1339 µg/g in patients with suspected necrotising enterocolitis (p = 0.0001). Patients with suspected necrotising enterocolitis had a significantly longer length of hospital stay, on average 18 days longer compared to patients without necrotising enterocolitis (p = 0.03). Faecal calprotectin concentrations may reflect severity of gut inflammation in neonates with CHD. Suspected necrotising enterocolitis contributes to longer days nil by mouth and an increase in length of hospital stay.

Keywords

CHDfaecal calprotectinnecrotising enterocolitissuspected necrotising enterocolitisfeeding
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 5 , May 2020 , pp. 624 - 628
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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