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Arch Dis Child Fetal Neonatal Ed


Title:Faecal volatile organic compounds in preterm babies at risk of necrotising enterocolitis: the DOVE study
Author(s):Probert C; Greenwood R; Mayor A; Hughes D; Aggio R; Jackson RE; Simcox L; Barrow H; Garcia-Finana M; Ewer AK;
Address:"Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. Department of Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Bristol, UK. Department of Biostatistics, Institute of Translation Medicine, University of Liverpool, Liverpool, UK. Neonatal Unit, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK. Neonatal Unit, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK a.k.ewer@bham.ac.uk. Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, Universityof Birmingham, Birmingham, UK"
Journal Title:Arch Dis Child Fetal Neonatal Ed
Year:2020
Volume:20191223
Issue:5
Page Number:474 - 479
DOI: 10.1136/archdischild-2019-318221
ISSN/ISBN:1468-2052 (Electronic) 1359-2998 (Linking)
Abstract:"BACKGROUND: Early diagnosis of necrotising enterocolitis (NEC) may improve prognosis but there are no proven biomarkers. OBJECTIVE: To investigate changes in faecal volatile organic compounds (VOCs) as potential biomarkers for NEC. DESIGN: Multicentre prospective study. SETTINGS: 8 UK neonatal units. PATIENTS: Preterm infants <34 weeks gestation. METHODS: Daily faecal samples were collected prospectively from 1326 babies of whom 49 subsequently developed definite NEC. Faecal samples from 32 NEC cases were compared with samples from frequency-matched controls without NEC. Headspace, solid phase microextraction gas chromatography/mass spectrometry was performed and VOCs identified from reference libraries. VOC samples from cases and controls were compared using both discriminant and factor analysis methods. RESULTS: VOCs were found to cluster into nine groups (factors), three were associated with NEC and indicated the possibility of disease up to 3-4 days before the clinical diagnosis was established. For one factor, a 1 SD increase increased the odds of developing NEC by 1.6 times; a similar decrease of the two other factors was associated with a reduced risk (OR 0.5 or 0.7, respectively). Discriminant analyses identified five individual VOCs, which are associated with NEC in babies at risk, each with an area under the receiver operating characteristics curve of 0.75-0.76, up to 4 days before the clinical diagnosis was made. CONCLUSIONS: Faecal VOCs are altered in preterm infants with NEC. These data are currently insufficient to enable reliable cotside detection of babies at risk of developing NEC and further work is needed investigate the role of VOCs in clarifying the aetiology of NEC"
Keywords:"Biomarkers Birth Weight Early Diagnosis Enterocolitis, Necrotizing/*diagnosis Feces/*chemistry Female Gestational Age Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases/*diagnosis Intensive Care Units, Neonatal Male Prospective Studies R;"
Notes:"MedlineProbert, Chris Greenwood, Rosemary Mayor, Arno Hughes, David Aggio, Raphael Jackson, Rachel Elizabeth Simcox, Liz Barrow, Heather Garcia-Finana, Marta Ewer, Andrew K eng MR/L010909/1/MRC_/Medical Research Council/United Kingdom MR/R024847/1/MRC_/Medical Research Council/United Kingdom Multicenter Study England 2019/12/25 Arch Dis Child Fetal Neonatal Ed. 2020 Sep; 105(5):474-479. doi: 10.1136/archdischild-2019-318221. Epub 2019 Dec 23"

 
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