Dani Carlo, Corsini Iuri, Generoso Marta, Gozzini Elena, Bianconi Tommaso, Pratesi Simone
Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Italy
Careggi University Hospital of Florence, Florence, Italy.
JPEN J Parenter Enteral Nutr. 2015 Nov;39(8):935-40. doi: 10.1177/0148607114538671. Epub 2014 Jun 16.
Feeding intolerance is very frequent in preterm infants, and the development of an early effective biomarker for its prediction could be useful for carrying out a proper feeding strategy. Our aim was to evaluate if the measurement of splanchnic regional oxygenation (rSO2S) and splanchnic fractional oxygen extraction ratio (FOES) using near-infrared spectroscopy (NIRS) is correlated with the time needed to achieve full enteral feeding and if it can predict the development of feeding intolerance.
We measured rSO2S and FOES in preterm infants 25 ± 0 to 31 ± 6 weeks of gestational age at 24-72 hours of life during continuous enteral feeding.
Linear regression analysis did not evidence any relationship between rSO2S and FOES and the time for achievement of full enteral feeding. Multivariate logistic regression analysis showed that birth weight <1000 g (relative risk [RR], 4.5; 95% confidence interval [CI], 1.23-16.45) and patent ductus arteriosus occurrence (RR, 9.3; 95% CI, 1.31-66.06) increased the risk of developing feeding intolerance in our population.
Splanchnic oxygenation and oxygen extraction measured in the first days of life are not correlated with the time needed to achieve full enteral feeding in preterm infants receiving continuous enteral nutrition.
喂养不耐受在早产儿中非常常见，开发一种早期有效的生物标志物用于预测喂养不耐受，可能有助于实施恰当的喂养策略。我们的目的是评估使用近红外光谱（NIRS）测量内脏区域氧合（rSO2S）和内脏氧摄取分数（FOES）是否与实现完全肠内喂养所需的时间相关，以及它是否能预测喂养不耐受的发生。
我们在胎龄25±0至31±6周的早产儿出生后24 - 72小时持续肠内喂养期间测量rSO2S和FOES。
线性回归分析未显示rSO2S和FOES与实现完全肠内喂养的时间之间存在任何关系。多因素逻辑回归分析表明，出生体重<1000 g（相对危险度[RR]，4.5；95%置信区间[CI]，1.23 - 16.45）和动脉导管未闭的发生（RR，9.3；95% CI，1.31 - 66.06）增加了我们研究人群中发生喂养不耐受的风险。
在接受持续肠内营养的早产儿出生后最初几天测量的内脏氧合和氧摄取与实现完全肠内喂养所需的时间无关。
