An exploratory physiological study of post-operative recovery in Surgical Neonates and Dimethylarginine:Arginine Levels (SuNDiAL)

Newborns who undergo major abdominal surgery often spend days or weeks unable to digest food, and a simple blood test taken before the operation could predict how long that recovery will take. The problem is that doctors currently have no reliable way to forecast recovery time for these fragile patients. Surgeons must wait and see how each baby responds, making it difficult to plan care, manage feeding tubes, or counsel parents. This study focuses on two molecules in the blood—ADMA and arginine—which are linked to blood flow and tissue healing. By measuring their levels before and just after surgery in neonates over 35 weeks gestation, researchers aim to see whether these markers correlate with the number of days a baby needs intravenous nutrition. If the link is confirmed, a preoperative blood test could give surgeons an early warning: a baby with an unfavourable ADMA-to-arginine ratio might need more intensive nutritional support or a slower reintroduction to feeding. This would allow neonatal intensive care units to tailor recovery plans from the start, potentially reducing complications and hospital stays. The research is exploratory and does not promise an immediate clinical tool, but it addresses a fundamental gap in understanding how newborn bodies respond to major surgical stress.