Plasma citrulline during the first 48 h after onset of necrotizing enterocolitis in preterm infants

BackgroundLevels of plasma citrulline (citrulline-P), a biomarker for enterocyte function, might be useful the monitoring course necrotizing enterocolitis (NEC). Our aim was to evaluate whether citrulline-P levels during first 48 h (h) after NEC onset were associated with need surgery, survival, and intestinal recovery.MethodsIn preterm infants (Bell's stage ≥2) we measured onset. Categorizing measurements into 0–8 h, 8–16 16–24 24–36 36–48 determined using linear regression analyses. Next, analyzed at 0–24 24–48 differed between conservative surgical treatment, survivors nonsurvivors, equal/below above total group's median time full enteral feeding (FEFt).ResultsWe included infants, gestational age 28.3 [IQR:26.0–31.4] weeks, birth weight 1200 [IQR:905–1524] grams. Citrulline-P decreased (B per interval: -1.40 μmol, 95% CI, −2.73 −0.07, p = 0.04). not nor survival. but higher in FEFt ≤20 days than >20 (20.7 [IQR:19.9–25.3] µmol/L (n 13) vs. 11.1 [IQR:8.4–24.0] 11), 0.049), cut-off value 12.3 μmol/L.ConclusionCitrulline-P onset, suggesting on-going injury. In survivors, measuring 24 may provide an indication recovery rate.