Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, 50141, Florence, Italy.
Eur J Pediatr. 2024 Dec;183(12):5313-5319. doi: 10.1007/s00431-024-05810-1. Epub 2024 Oct 10.
Cyclic phototherapy (cPT) can achieve a reduction in total serum bilirubin comparable to that achieved with standard continuous PT in preterm infants. Our aim was to assess the effect of cPT on splanchnic (rSOS) and cerebral (rSOC) oxygenation measured by near-infrared spectroscopy (NIRS). We prospectively studied 16 infants with a gestational age of 25-34 weeks with hyperbilirubinemia requiring PT. Splanchnic regional oxygenation (rSOS), oxygen extraction fraction (FOES), and cerebro-splanchnic oxygenation ratio (CSOR) were recorded before, during, and after cPT discontinuation. We found that rSOS, FOES, and CSOR did not change during the study period. The overall duration of single or multiple courses of PT was 6.5 (6.0-13.5) h, but by cycling PT, the actual exposure was 3.0 (1.5-4.9) h. Twelve patients (75%) required 15 min/h cPT, and four (25%) required prolonging cPT to 30 min/h. None of the patients developed enteral feeding intolerance. Conclusions: cPT treatment of hyperbilirubinemia in preterm infants does not affect splanchnic oxygenation or intestinal oxygen blood extraction, likely due to the short exposure to PT light, and it could contribute to decreasing the risk of feeding intolerance.
周期性光疗（cPT）可使早产儿总血清胆红素降低，与标准持续光疗（CPT）相当。我们的目的是评估 cPT 对近红外光谱（NIRS）测量的内脏（rSOS）和大脑（rSOC）氧合的影响。我们前瞻性研究了 16 名胎龄 25-34 周、需要 CPT 的高胆红素血症早产儿。在 cPT 停止前、中、后记录内脏区域氧饱和度（rSOS）、氧摄取分数（FOES）和脑-内脏氧合比（CSOR）。我们发现，在研究期间，rSOS、FOES 和 CSOR 没有变化。单次或多次 CPT 的总持续时间为 6.5（6.0-13.5）小时，但通过循环 CPT，实际暴露时间为 3.0（1.5-4.9）小时。12 名患者（75%）需要 15 分钟/小时的 CPT，4 名患者（25%）需要延长 CPT 至 30 分钟/小时。没有患者出现肠道喂养不耐受。结论：cPT 治疗早产儿高胆红素血症不会影响内脏氧合或肠道氧摄取，可能是由于 CPT 光暴露时间短，有助于降低喂养不耐受的风险。
