Department of Physiology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic.
Physiol Res. 2022 Dec 31;71(S2):S179-S186. doi: 10.33549/physiolres.935002.
Phototherapy is the most effective non-invasive method of neonatal hyperbilirubinemia treatment. Application of this method can be associated with side effects including changes in the cardiovascular system. During phototherapy, the primary effects in the cardiovascular system include cutaneous vasodilation leading to skin hyperperfusion and subsequent redistribution of blood. The increased blood flow through the skin is associated with increased transepidermal water loss. Further effects include an increase in cerebral blood flow. Redistribution of blood to the cutaneous bed is compensated by hypoperfusion in the splanchnic area (mostly postprandial) and a significant reduction of the renal blood flow. Regarding closure/reopening of the ductus arteriosus, the results suggest that that phototherapy does not affect ductal patency. During phototherapy the cardiac output can be slightly reduced due to a decreased stroke volume, especially in preterm newborns. Systemic blood pressure is decreased and heart rate is elevated in both preterm and term newborns during phototherapy. The heart rate variability is slightly reduced. Symbolic dynamics analysis of the short-term HRV showed that during phototherapy the activity of the ANS regulating the heart rate is shifted towards the dominancy of the sympathetic activity. The responses in the cardiovascular system of premature/mature newborns without other pathology confirm a well physiologically functioning control of this system, even under specific conditions of phototherapy.
光疗是治疗新生儿高胆红素血症最有效的非侵入性方法。应用这种方法可能会产生副作用，包括心血管系统的变化。在光疗过程中，心血管系统的主要影响包括皮肤血管扩张，导致皮肤过度充血和随后的血液再分布。通过皮肤的血流量增加与经皮水分丢失增加有关。进一步的影响包括大脑血液流量增加。皮肤床的血液再分布通过内脏区域（主要是餐后）的灌注不足和肾血流量的显著减少来代偿。关于动脉导管的关闭/再开放，结果表明光疗不会影响导管的通畅性。在光疗过程中，由于心搏量减少，心输出量可能会略有降低，尤其是在早产儿中。在光疗过程中，无论是早产儿还是足月儿，血压均降低，心率升高。心率变异性略有降低。短期心率变异性的符号动力学分析表明，在光疗过程中，调节心率的自主神经系统的活动向交感神经活动的主导性转移。在没有其他病理的早产儿/足月儿的心血管系统反应证实了该系统的良好生理功能控制，即使在光疗的特定条件下也是如此。
