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Impact of Continuous vs Bolus Feeding on Splanchnic Perfusion in Very Low Birth Weight Infants: A Randomized Trial

Valentina Bozzetti1, Giuseppe Paterlini1, Paola De Lorenzo2

  • 1Neonatal Intensive Care Unit, MBBM Foundation, San Gerardo Hospital, Monza, Italy.

The Journal of Pediatrics
|June 25, 2016
PubMed

Insights

Bolus feeding significantly enhances splanchnic perfusion compared to continuous feeding in infants. This method is more effective for improving blood flow in the intestines of both intrauterine growth restriction (IUGR) and non-IUGR infants.

Area of Science:

  • Neonatal Physiology
  • Gastrointestinal Health
  • Pediatric Nutrition

Background:

  • Infants with intrauterine growth restriction (IUGR) may have altered splanchnic perfusion.
  • Optimizing enteral feeding strategies is crucial for the well-being of preterm infants.
  • Understanding the impact of feeding methods on intestinal blood flow is essential.

Purpose of the Study:

  • To compare the effects of bolus versus continuous enteral feeding on splanchnic perfusion and oxygenation.
  • To evaluate these effects in very low birth weight infants, with and without IUGR.
  • To determine the optimal feeding regimen for enhancing intestinal blood flow.

Main Methods:

  • A randomized trial involving 40 very low birth weight infants (IUGR and non-IUGR).
  • Two feeding groups: Group A (bolus then continuous) and Group B (continuous then bolus).
  • Splanchnic perfusion assessed by superior mesenteric artery Doppler ultrasound; oxygenation by near-infrared spectroscopy.

Main Results:

  • Superior mesenteric artery Doppler ultrasound revealed significantly higher splanchnic perfusion following bolus feeds compared to continuous feeds.
  • Near-infrared spectroscopy measurements for oxygenation remained stable across both feeding methods.
  • Infants with and without IUGR exhibited similar perfusion and oxygenation patterns.

Conclusions:

  • Bolus enteral feeding demonstrates superior efficacy in augmenting splanchnic perfusion over continuous feeding.
  • This finding suggests bolus feeding may be a more effective strategy for improving intestinal blood flow in vulnerable infants.
  • Further research can explore long-term outcomes associated with different feeding regimens.
Abstract

Keywords:
IUGRNIRSSMA Dopplerbolus nutritioncontinuous nutritionsplanchnic oxygenation

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