Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
Department of Biomedical Engineering.
J Pediatr Gastroenterol Nutr. 2018 Jun;66(6):e146-e152. doi: 10.1097/MPG.0000000000001867.
The aim of the study was to obtain objective measures indicative of gastrointestinal maturity using 3 noninvasive technologies.
Electrogastrography (EGG), abdominal near-infrared spectroscopy (NIRS), and bowel sound/acoustics (AC) monitoring were used simultaneously to obtain physiologic measures of the gastrointestinal system of 18 preterm and 5 term neonates who were tolerating enteral feedings. Measures of EGG slow wave voltage (EGG dominant power) and AC signal amplitude (AC dominant power) were obtained after spectral density analysis. Mean abdominal regional saturations (A-rSO2) were obtained directly from NIRS. The relationship of these 3 measures with postmenstrual age (PMA) was assessed.
The results of the 3 methods differed depending on whether the measurements were pre- or postprandial. Postprandial EGG dominant power increases with PMA (r = 0.67, P = 0.003), both pre- and postprandial abdominal NIRS mean regional saturation increase with PMA (r = 0.73, P < 0.001 and r = 0.55, P = 0.009), and postprandial AC dominant power (at 300-500 Hz) increases with PMA (r = -0.48, P = 0.025).
EGG, abdominal NIRS, and AC, whenever used simultaneously, can provide objective and synergistic measures that correlate with PMA. These findings may be helpful in the assessment of feeding readiness because they reveal quantitative measures suggestive of the developmental process of the gut.
本研究旨在使用 3 种非侵入性技术获得提示胃肠道成熟度的客观指标。
同时使用胃电图(EGG)、腹部近红外光谱(NIRS)和肠鸣音/声音(AC)监测来获得 18 名早产儿和 5 名足月儿的胃肠道生理测量值,这些婴儿均能耐受肠内喂养。在进行频谱密度分析后,获得 EGG 慢波电压(EGG 主导功率)和 AC 信号幅度(AC 主导功率)的测量值。直接从 NIRS 获得平均腹部区域饱和度(A-rSO2)。评估这 3 种方法与胎龄(PMA)的关系。
3 种方法的结果因测量是在餐前还是餐后而有所不同。餐后 EGG 主导功率随 PMA 增加(r=0.67,P=0.003),餐前和餐后腹部 NIRS 平均区域饱和度随 PMA 增加(r=0.73,P<0.001 和 r=0.55,P=0.009),餐后 AC 主导功率(在 300-500 Hz 之间)随 PMA 增加(r=-0.48,P=0.025)。
EGG、腹部 NIRS 和 AC 只要同时使用,就可以提供与 PMA 相关的客观且协同的测量值。这些发现可能有助于评估喂养准备情况,因为它们揭示了提示肠道发育过程的定量指标。