Faculty of Biology, University of Pavia, Pavia, Italy.
Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, Alessandria, Italy.
Acta Paediatr. 2018 Feb;107(2):234-239. doi: 10.1111/apa.14099. Epub 2017 Oct 24.
The effects of different milk and, or, administration regimens on cerebro-splanchnic perfusion are still a matter of debate. We investigated the effects of the bolus administration of breast milk or formula on cerebro-splanchnic oximetry, function and perfusion, assessed by near-infrared spectroscopy (NIRS).
This observational study of 30 infants fed with breast (n = 15) or formula (n = 15) milk, and matched for gestational age and birth weight, was carried out in the neonatal intensive care unit of the C Arrigo Children's Hospital, Alessandria, Italy, a tertiary-level referral centre, from October 2015 to December 2016. NIRS monitoring parameters, such as cerebral and splanchnic oximetry, fraction of tissue oxygen extraction and the cerebral-splanchnic ratio, were recorded before, during and after feeding.
Breast milk led to a significant increase in cerebro-splanchnic oximetry and tissue oxygen extraction (p < 0.001) during and after feeding, and the cerebro-splanchnic perfusion ratio was significantly higher (p < 0.001) in the breast than formula group.
Our study results suggest that breast milk was better tolerated than formula, requiring lower energy expenditure and lower cerebro-splanchnic haemodynamic redistribution. The findings could prompt investigations using NIRS as a promising noninvasive tool for cerebral and splanchnic longitudinal monitoring during neonatal feeding.
不同的牛奶和/或给药方案对脑-内脏灌注的影响仍存在争议。我们通过近红外光谱(NIRS)研究了母乳或配方奶推注对脑-内脏氧合、功能和灌注的影响。
本研究为 2015 年 10 月至 2016 年 12 月在意大利亚历山德里亚 C Arrigo 儿童医院新生儿重症监护病房进行的一项观察性研究,纳入 30 例母乳喂养(n=15)或配方奶喂养(n=15)的婴儿,两组在胎龄和出生体重方面相匹配。NIRS 监测参数,如脑和内脏氧合、组织氧摄取分数和脑-内脏比值,在喂养前、喂养中和喂养后进行记录。
母乳在喂养中和喂养后可显著增加脑-内脏氧合和组织氧摄取(p<0.001),且脑-内脏灌注比值显著高于(p<0.001)配方奶组。
我们的研究结果表明,母乳比配方奶更耐受,需要较低的能量消耗和较低的脑-内脏血液动力学再分布。这些发现可能促使使用 NIRS 作为一种有前途的非侵入性工具进行新生儿喂养期间的脑和内脏纵向监测的研究。