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Changes in mesenteric blood flow response to feeding: conventional versus fiber-optic phototherapy
M Pezzati1, R Biagiotti, V Vangi
1Department of Pediatrics, Division of Neonatology, University of Firenze School of Medicine, Firenze, Italy. pezzati@cesit1.unifi.it
Insights
Fiber-optic phototherapy better supports infant digestion than conventional methods. It preserves essential blood flow to the gut after feeding, unlike traditional phototherapy which can hinder this vital process in preterm infants.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Medical Physics
Background:
- Preterm infants often require phototherapy for hyperbilirubinemia.
- Conventional phototherapy may impact mesenteric blood flow, crucial for nutrient absorption.
- Understanding phototherapy's effects on neonatal circulation is vital for optimizing care.
Purpose of the Study:
- To compare the effects of fiber-optic and conventional phototherapy on postprandial mesenteric blood flow velocity in preterm infants.
- To determine if fiber-optic phototherapy preserves the normal increase in intestinal blood flow after feeding.
Main Methods:
- Doppler color ultrasonography was used to measure superior mesenteric artery blood flow velocity pre- and postprandially.
- Measurements were taken in 19 preterm infants during/after conventional phototherapy and 20 during/after fiber-optic phototherapy.
- The mean arterial blood pressure/mean flow velocity ratio estimated relative vascular resistance.
Main Results:
- Conventional phototherapy significantly blunted the postprandial increase in mesenteric blood flow.
- Fiber-optic phototherapy did not attenuate the postprandial increase in intestinal blood flow.
- Postprandial blood flow increase was significantly greater with fiber-optic compared to conventional phototherapy.
- Fiber-optic phototherapy led to a greater reduction in postprandial vascular resistance.
Conclusions:
- Fiber-optic phototherapy is preferable for treating hyperbilirubinemia in preterm infants.
- Unlike conventional methods, fiber-optic phototherapy does not impede the normal postprandial redistribution of blood flow to the gastrointestinal system.
Objective:
To evaluate whether fiberoptic phototherapy influences the postprandial increase in mesenteric blood flow velocity similarly to conventional phototherapy in preterm infants.
Patients And Methods:
With the use of Doppler color ultrasonography, blood flow velocity in the superior mesenteric artery was measured both preprandially and postprandially in 19 preterm infants during and after conventional phototherapy, and in 20 preterm infants during and after fiber-optic phototherapy. The mean arterial blood pressure/mean flow velocity ratio was calculated as an estimate of relative vascular resistance of the superior mesenteric artery.
Results:
The study shows that conventional phototherapy blunts the postprandial mesenteric blood flow response to feeding in preterm infants. Furthermore, it shows that the postprandial increase in intestinal blood flow is not attenuated when fiber-optic phototherapy is administered, and that such postprandial increase of blood flow is significantly greater than in infants receiving conventional phototherapy. During and after fiber-optic phototherapy, a significant reduction in postprandial relative vascular resistance was found; such reduction was significantly greater than during conventional phototherapy.
Conclusions:
Fiber-optic phototherapy is preferable to conventional phototherapy for the treatment of hyperbilirubinemia in preterm infants because it does not affect the physiologic postprandial redistribution of blood flow from the periphery to the gastrointestinal system as does conventional phototherapy.