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早产儿高胆红素血症光疗时内脏氧合。

Splanchnic oxygenation during phototherapy in preterm infants with hyperbilirubinemia.

机构信息

Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy; Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy.

Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.

出版信息

Early Hum Dev. 2022 Oct;173:105662. doi: 10.1016/j.earlhumdev.2022.105662. Epub 2022 Sep 1.

DOI:10.1016/j.earlhumdev.2022.105662
PMID:36084536
Abstract

BACKGROUND

It has been reported that preterm infants can develop feeding intolerance during phototherapy (PT) and that PT can affect mesenteric perfusion in these patients.

AIMS

Our aim was to assess if PT can decrease regional splanchnic oxygenation (rSOS) measured by near infrared spectroscopy (NIRS).

STUDY DESIGN

We prospectively studied infants with gestational age of 25-34 weeks with hyperbilirubinemia requiring PT. Splanchnic regional oxygenation (rSOS), oxygen extraction fraction (FOES), and cerebrosplanchnic oxygenation ratio (CSOR) were recorded before, during, and after PT discontinuation.

RESULTS

During PT rSOS and CSOR significantly decreased and this effect lasted for some hours after its interruption. FOES contemporary increased, although this effect was not statistically significant.

CONCLUSIONS

PT treatment decreases splanchnic oxygenation in preterm infants likely due to peripheral vasodilation which triggers a redistribution of blood flow. These results can help explain the association between PT and the development of feeding intolerance in preterm infants.

摘要

背景

据报道,早产儿在光疗(PT)期间可能会出现喂养不耐受,而 PT 可能会影响这些患者的肠系膜灌注。

目的

我们的目的是评估 PT 是否会降低近红外光谱(NIRS)测量的局部内脏氧合(rSOS)。

研究设计

我们前瞻性研究了胎龄为 25-34 周、需要 PT 的高胆红素血症早产儿。在 PT 开始前、进行中和停止后记录内脏区域氧合(rSOS)、氧提取分数(FOES)和脑内脏氧合比(CSOR)。

结果

在 PT 期间,rSOS 和 CSOR 显著降低,这种影响在 PT 停止后持续数小时。FOES 同时增加,但这一效应无统计学意义。

结论

PT 治疗降低了早产儿的内脏氧合,可能是由于外周血管扩张导致血流重新分布所致。这些结果可以帮助解释 PT 与早产儿喂养不耐受发展之间的关联。

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