Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Viale Morgagni, Florence, Italy.
J Pediatr Gastroenterol Nutr. 2013 Jun;56(6):652-6. doi: 10.1097/MPG.0b013e318287e9d7.
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.
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).
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.
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.
本研究旨在比较持续和间歇推注式喂奶对小于胎龄儿(SGA)和适于胎龄儿(AGA)早产儿内脏区域氧合(rSO₂S)的影响。
通过近红外光谱法对胎龄 <32 周的婴儿进行前瞻性研究。每个婴儿在约 10 分钟内给予牛奶推注(间歇喂养),然后在 3 小时后进行 3 小时连续喂养。rO₂S 和内脏氧摄取分数(FOES[S=内脏])在推注喂养前 30 分钟(T₀)和开始后 30 分钟(T₁)、前 30 分钟(T₂)、结束时(T₃)和连续喂养期结束后 30 分钟(T₄)记录。
AGA 和 SGA 两组 rSO2S 在 T₁时均升高,而 FOES 在研究期间无变化。此外,我们发现 AGA 组在 T₁和 T₃时 rSO2S 更高,FOES 更低。
推注式喂奶可增加 AGA 和 SGA 婴儿的内脏氧合,而连续喂养则不行。在推注和连续喂养期间,AGA 婴儿的内脏氧合均高于 SGA 婴儿。连续肠内喂养有助于限制危重症早产儿缺氧缺血性肠道损伤的风险,尤其是 AGA 婴儿。