Abstract
The intestinal circulation normally meets the bowel's metabolic needs, but adaptive responses may sacrifice flow to the intestine to preserve the oxygenation of other organs. Severe or prolonged hypoxia associated with birth asphyxia or intrauterine growth restriction may predispose to necrotizing enterocolitis (NEC) by repeated or persistent redistribution of blood flow away from the bowel. Immature autoregulation of gut blood flow in the face of such challenges may explain the susceptibility of neonates to gut ischaemia. Other factors reducing intestinal blood flow may interact with the increased metabolic demands imposed by enteral feeding to contribute to the development of NEC.
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