内脏组织氧合能力用于预测早产儿喂养耐受性

　　背景：早产儿中的喂养不耐受非常普遍，早期检测的有效生物标记物的发展对实施一项合理的治疗方案非常有用。我们旨在利用近红外光谱仪（NIRS）来评估内脏局部氧合能力（rSO2S）以及内脏分次氧摄取率（FOES）是否与获取充足肠内喂养的时间有关，同时评估它是否可以预测喂养不耐受的进展。

　　资料与方法：我们检测了孕周为25±0至31±6周的早产儿出生后24～72小时在连续肠内喂养期间的rSO2S和FOES。

　　结果：线性回归分析的结果并没有得到rSO2S和FOES与获取充足肠内喂养的时间之间的相关性证据。多变量逻辑回归分析显示出生体重＜1000g（相对危险度[RR]：4.5；95%可信区间[CI]：1.23～16.45）、动脉导管未闭的发生（RR：9.3；95%CI：1.31～66.06）增加了喂养不耐受的风险。

　　结论：在接受持续肠内营养的早产儿中，对出生早期内脏氧合能力和内脏氧摄取率的检测与获取充足肠内喂养的时间没有相关性。

JPEN J Parenter Enteral Nutr. 2015 Nov;39(8):935-40.

Splanchnic Tissue Oxygenation for Predicting Feeding Tolerance in Preterm Infants.

Dani C, Corsini I, Generoso M, Gozzini E, Bianconi T, Pratesi S.

University of Florence, Italy.

Careggi University Hospital of Florence, Florence, Italy.

BACKGROUND: Feeding intolerance is very frequent in preterm infants, and the development of an early effective biomarker for its prediction could be useful for carrying out a proper feeding strategy. Our aim was to evaluate if the measurement of splanchnic regional oxygenation (rSO2S) and splanchnic fractional oxygen extraction ratio (FOES) using near-infrared spectroscopy (NIRS) is correlated with the time needed to achieve full enteral feeding and if it can predict the development of feeding intolerance.

MATERIALS AND METHODS: We measured rSO2S and FOES in preterm infants 25 ± 0 to 31 ± 6 weeks of gestational age at 24-72 hours of life during continuous enteral feeding.

RESULTS: Linear regression analysis did not evidence any relationship between rSO2S and FOES and the time for achievement of full enteral feeding. Multivariate logistic regression analysis showed that birth weight <1000 g (relative risk [RR], 4.5; 95% confidence interval [CI], 1.23-16.45) and patent ductus arteriosus occurrence (RR, 9.3; 95% CI, 1.31-66.06) increased the risk of developing feeding intolerance in our population.

CONCLUSION: Splanchnic oxygenation and oxygen extraction measured in the first days of life are not correlated with the time needed to achieve full enteral feeding in preterm infants receiving continuous enteral nutrition.

KEYWORDS: continuous feeding; feeding tolerance; near infrared spectroscopy; preterm infants

PMID: 24934405

DOI: 10.1177/0148607114538671