Splanchnic oxygenation during phototherapy in preterm infants with hyperbilirubinemia

Background: It has been reported that preterm infants can develop feeding intolerance during phototherapy (PT) and that PT can affect mesenteric perfusion in these patients. Aims: Our aim was to assess if PT can decrease regional splanchnic oxygenation (rSO(2)S) measured by near infrared spectroscopy (NIRS). Study design: We prospectively studied infants with gestational age of 25-34 weeks with hyperbilirubinemia requiring PT. Splanchnic regional oxygenation (rSO(2)S), oxygen extraction fraction (FOES), and cerebrosplanchnic oxygenation ratio (CSOR) were recorded before, during, and after PT discontinuation. Results: During PT rSO(2)S and CSOR significantly decreased and this effect lasted for some hours after its interruption. FOES contemporary increased, although this effect was not statistically significant. Conclusions: PT treatment decreases splanchnic oxygenation in preterm infants likely due to peripheral vasodilation which triggers a redistribution of blood flow. These results can help explain the association between PT and the development of feeding intolerance in preterm infants.

Automated summary

During phototherapy, regional mesenteric oxygenation and cerebrosplanchnic oxygenation ratio significantly decrease in preterm infants, while oxygen extraction fraction increases. These effects may last for several hours and are likely due to peripheral vasodilation triggering blood flow redistribution.