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How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
Near-infrared spectroscopy measurements of splanchnic tissue oxygenation during continuous versus intermittent
Carlo Dani1, Simone Pratesi, Jacopo Barp
1Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Viale Morgagni, Florence, Italy. cdani@unifi.It
Insights
Bolus milk feeding enhances splanchnic oxygenation in preterm infants. Continuous feeding did not show this effect, and appropriate-for-gestational age infants had better oxygenation than small-for-gestational age infants.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Physiology
Background:
- Preterm infants, especially those small-for-gestational age (SGA), are at risk for gastrointestinal complications.
- Assessing splanchnic oxygenation is crucial for managing preterm infants.
Purpose of the Study:
- To compare the impact of continuous versus intermittent bolus milk feeding on splanchnic regional oxygenation (rSO₂S) in preterm infants.
- To evaluate differences in oxygenation between appropriate-for-gestational age (AGA) and SGA infants.
Main Methods:
- Near-infrared spectroscopy (NIRS) was used to measure rSO₂S in preterm infants (<32 weeks gestational age).
- Infants received intermittent bolus feeding followed by continuous feeding.
- Splanchnic fractional oxygen extraction ratio (FOES) was also recorded.
Main Results:
- Bolus milk feeding increased rSO₂S in both AGA and SGA infants.
- AGA infants exhibited higher rSO₂S and lower FOES compared to SGA infants during feeding.
- Continuous feeding did not significantly alter rSO₂S.
Conclusions:
- Intermittent bolus milk feeding improves splanchnic oxygenation in preterm infants.
- Continuous enteral feeding may be beneficial in preventing hypoxic-ischemic gut injury, particularly in AGA infants.
- SGA infants demonstrate lower splanchnic oxygenation compared to AGA infants.
Objectives:
The aim of the present study was to compare the effects of continuous and intermittent bolus milk feeding on splanchnic regional oxygenation (rSO₂S) in small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) preterm infants.
Methods:
Infants with gestational age <32 weeks were prospectively studied by near-infrared spectroscopy. Each infant was given a milk bolus in ~10 minutes (intermittent feeding) followed after 3 hours by a 3-hour continuous feeding. rO₂S and splanchnic fractional oxygen extraction ratio (FOES [S = splanchnic]) were recorded 30 minutes before (T₀) and 30 minutes after the beginning of bolus feeding (T₁), 30 minutes before (T₂), at the end (T₃), and 30 minutes after the continuous feeding period (T₄).
Results:
rSO2S increased at T₁ in both AGA and SGA groups, whereas FOES did not vary during the study period. Moreover, we found that rSO2S was higher and FOES was lower at T₁ and T₃ in the AGA than in the SGA group.
Conclusions:
Bolus milk feeding increases splanchnic oxygenation in both AGA and SGA infants, whereas continuous feeding does not. Splanchnic oxygenation is higher in AGA than in SGA infants both during bolus and continuous feeding. Continuous enteral feeding could help to limit the risk of hypoxic-ischemic gut damage in preterm infants in critical condition, especially in AGA infants.
