Background and Aims Bolus and continuous tube feeding represent the most frequently used enteral feeding techniques in preterm infants, but the best strategy is not yet established. Near-Infrared-Spectroscopy (NIRS) provides a noninvasive monitoring of splanchnic oxygenation, which may play a role in the multifactorial pathophysiology of necrotizing enterocolitis (NEC).
The aim of this study is to evaluate by NIRS the effects of bolus and continuous enteral feeding on splanchnic and cerebral oxygenation in preterm infants with normal feeding tolerance.
Methods Eighteen healthy preterms (GA 27–32 weeks), tolerating at least 100 ml/kg-1/day-1 of fortified human milk or preterm formula, underwent a 6-hours simultaneous monitoring of cerebral and splanchnic oxygenation using NIRO-200 oximeter. Sensors were placed on frontal and sub-umbilical region. During the monitoring they randomly received a 10-minutes bolus meal and a 3 hours continuous meal.
Recorded values of cerebral and splanchnic Tissue Oxygenation Index (TOI) were clustered in 5-minutes intervals and compared between different feeding techniques using Wilcoxon Signed Ranks Test. Statistical significance was set at p≤0.05.
Results Splanchnic oxygenation significantly decreased (p<0.05) during continuous feeding, from 1.30’ hour after the beginning to almost the end of the feed. No differences were found on cerebral oxygenation.
Conclusions To the best of our knowledge, this is the first study comparing the effect of different feeding techniques on splanchnic and cerebral oxygenation in preterms. A significant reduction in splanchnic oxygenation was observed during continuous enteral. A possible role of these findings on the multifactorial NEC pathogenesis remains to be investigated.