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Updated: May 6, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Splanchnic and cerebral oxygenation during cyclic phototherapy in preterm infants with hyperbilirubinemia
Carlo Dani1,2, Giulia Remaschi3, Federica Rossi3
1Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy. carlo.dani@unifi.it.
Insights
Cyclic phototherapy (cPT) for infant hyperbilirubinemia is safe, showing no impact on splanchnic oxygenation. This approach may reduce the risk of feeding intolerance in preterm infants.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Medical Technology
Background:
- Hyperbilirubinemia is common in preterm infants, often treated with phototherapy (PT).
- Cyclic phototherapy (cPT) offers comparable bilirubin reduction to continuous PT but with reduced light exposure.
- Concerns exist regarding PT's effect on infant organ oxygenation and feeding tolerance.
Purpose of the Study:
- To evaluate the impact of cPT on splanchnic and cerebral oxygenation in preterm infants.
- To assess changes in oxygen extraction and cerebro-splanchnic oxygenation ratio during cPT.
- To determine if cPT influences the incidence of enteral feeding intolerance.
Main Methods:
- Prospective study of 16 preterm infants (25-34 weeks gestation) with hyperbilirubinemia requiring PT.
- Near-infrared spectroscopy (NIRS) used to measure splanchnic regional oxygenation (rSO2S) and cerebral oxygenation (rSO2C).
- Measurements taken before, during, and after cPT; oxygen extraction fraction (FOES) and cerebro-splanchnic oxygenation ratio (CSOR) calculated.
Main Results:
- No significant changes observed in rSO2S, FOES, or CSOR during the study period.
- Actual cPT exposure time averaged 3.0 hours, significantly less than the overall treatment duration.
- No patients experienced enteral feeding intolerance; 75% received 15 min/h of cPT.
Conclusions:
- Cyclic phototherapy does not adversely affect splanchnic oxygenation or intestinal oxygen extraction in preterm infants.
- The reduced light exposure in cPT is likely responsible for maintaining stable oxygenation.
- cPT is a safe alternative that may decrease the risk of feeding intolerance in this population.
Abstract:
Cyclic phototherapy (cPT) can achieve a reduction in total serum bilirubin comparable to that achieved with standard continuous PT in preterm infants. Our aim was to assess the effect of cPT on splanchnic (rSO2S) and cerebral (rSO2C) oxygenation measured by near-infrared spectroscopy (NIRS). We prospectively studied 16 infants with a gestational age of 25-34 weeks with hyperbilirubinemia requiring PT. Splanchnic regional oxygenation (rSO2S), oxygen extraction fraction (FOES), and cerebro-splanchnic oxygenation ratio (CSOR) were recorded before, during, and after cPT discontinuation. We found that rSO2S, FOES, and CSOR did not change during the study period. The overall duration of single or multiple courses of PT was 6.5 (6.0-13.5) h, but by cycling PT, the actual exposure was 3.0 (1.5-4.9) h. Twelve patients (75%) required 15 min/h cPT, and four (25%) required prolonging cPT to 30 min/h. None of the patients developed enteral feeding intolerance. Conclusions: cPT treatment of hyperbilirubinemia in preterm infants does not affect splanchnic oxygenation or intestinal oxygen blood extraction, likely due to the short exposure to PT light, and it could contribute to decreasing the risk of feeding intolerance.
