1389 BREATH HYDROGEN IN PREMATURE INFANTS

Abstract

Breath hydrogen (H2) analysis is used to evaluate carbohydrate absorption, gut motility and perfusion and the number and location of bacteria in the bowel. As these same factors are important in the development of necrotizing enterocolitis (NEC), we tested the hypothesis that breath H2 could be a useful diagnostic tool in NEC. NEC was defined by the presence of clinical signs and pneumatosis. Feeding intolerance episodes were defined by the absence of pneumatosis and rapid resolution of clinical signs after being NPO and on antibiotics. Samples were collected during expiration and analyzed by gas chromatography. Results are shown below: a) 15 infants with NEC, b) 12 with feeding intolerance, c) 12 fed but on antibiotics, and d) 20 healthy during feedings. Infants with NEC had higher levels than infants also on antibiotic and/or NPO without NEC. NEC infants with undeteotable H2 levels (2 “false negatives”) were on antibiotics and/or NPO since birth. These findings suggest that breath H2 may be a useful tool in the early differentiation of infants with NEC from those with feeding intolerance or other gastrointestinal disorders.