Splanchnic oxygenation patterns at first feed in stable preterm infants: Correlation with feeding intolerance development

Abstract

Introduction and aim: Due to their gastro-intestinal immaturity, preterm infants aremore prone to develop feeding intolerance (FI), which frequently hampers the establishment of an adequate enteral nutrition. Previous Doppler studies showed an impaired mesenteric bloodflowvelocity after thefirst feed inpreterm infants developing FI. We aimed to evaluate splanchnic oxygenation patterns in response to the first enteral feed and possible correlations with subsequent FI development. Methods: Stable preterm infants (gestational age ≤34 weeks) underwent a 3-hourNear-Infrared Spectroscopymonitoring at first enteral feed administration. The enrolled infants were retrospectively allocated into 2 groups in relation to the development of FI during their hospital stay (food intolerance [FI] vs. food tolerance [FT]). Mann–Whitney U test was used to compare splanchnic oxygenation patterns between the two groups. Statistical significance was set at p<0.05. Results: Seventy-eight preterm infants were enrolled; 30 out of 78 developed FI during their hospital stay. Splanchnic oxygenation patterns in response to the first feed differed significantly between two groups, with lower values of splanchnic tissue oxygenation in the FI group during the first 35′ after the first feed and from 1h 30′ on (p<0.05). Conclusions: Splanchnic oxygenation in response to the first enteral feed is significantly lower in preterm infants developing FI. This finding could reflect an early impairment of mesenteric regional circulation with subsequent tissue hypoxia, which might possibly predispose to the development of FI.