Play all audios:
Background: Early feeding of extremely preterm (EP) infants is essential for the development of the gastrointestinal tract. Nevertheless, optimal feeding strategy is unclear. Near infrared
spectroscopy (NIRS), measuring cerebro-splanchnic oxygenation ratio (CSOR), detects in neonates changes in splanchnic oxygen delivery during apnea and predicts ischemia.
Aim: To study variations of CSOR in EP infants in relationship to initiation of enteral feeds.
Design Methods: In 9 EP infants born < 28 weeks gestational age, NIRS measurements were recorded: before (T0), directly after (T1), one day (T2) and one week after (T3) initiation of feeds.
Clinical variables were recorded including the primary outcome: time to full feeds.
Results: Patients characteristics and outcomes in mean ± SD or number of patients were: gestational age: 25.2±0.9 weeks, birth weight: 764±134 grams, sex: 4 females, Apgar score at 10
minutes: 8±2.06, time to full feeds: 19±7 days, incidence of necrotizing enterocolitis: 2, patent ductus arteriosus (PDA) treated with ibuprofen: 2, PDA ligation: 6, mortality rate: 1.
We observed significant differences between each period for individual patients. Mean CSOR values for each period were 1.4±0.4, 1.7±0.9, 1.5±0.7, and 1.6±0.9 for T0, T1, T2 and T3
respectively (NS). We found a correlation between CSOR at T3 and percent of enteral feeds (p=0.0533, r=0.489), adjusted for birth weight (p=0.0492, r=0.501). Six infants requiring PDA
ligation showed higher CSOR values at T3: 1.908±0.92 compared to 0.913±0.116 (NS).
Conclusion: This pilot study suggests that CSOR can be used in EP infants to assess feeding intolerance and to optimize individual feeding strategies.
Anyone you share the following link with will be able to read this content: