Didem Arman, Serdar Cömert, Nursu Kara, Adem Gül, Kudret Ebru Erol
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Time to reach full enteral nutrition and hospital stay were significantly shorter in the study group (p = 0.049, p = 0.016). Infants in the study group experienced less feeding intolerance (p = 0.006). No infant developed necrotizing enterocolitis (NEC) in both groups. No difference was determined in pre- and post-feeding cerebral rSO<sub>2</sub> measurements during TH and normothermia. Mesenteric rSO<sub>2</sub>, CSOR, and mesenteric blood flow measurements in the study group during normothermia were significantly increased, respectively (p = 0.03, p < 0.01, p < 0.01).</p><p><strong>Conclusion: </strong>In our study, we observed that MEN during TH does not lead to a significant change in cerebral and mesenteric oxygenation. Although we did not observe an increase in blood flow and oxygenation, the absence of NEC and a lower incidence of feeding intolerance in the study group may suggest that feeding during TH is safe and feasible.</p><p><strong>Impact: </strong>MEN during TH treatment does not lead to a significant change in cerebral and mesenteric oxygenation. This is the first study evaluating the effects of MEN on mesenteric oxygenation and blood flow velocities in infants with hypoxic-ischemic encephalopathy during TH with Doppler USG and NIRS, concomitantly. MEN during TH may be safe and feasible.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effects of nutrition on mesenteric oxygenation among neonates with neonatal encephalopathy: a randomized clinical trial.\",\"authors\":\"Didem Arman, Serdar Cömert, Nursu Kara, Adem Gül, Kudret Ebru Erol\",\"doi\":\"10.1038/s41390-024-03648-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We aimed to evaluate the effects of minimal enteral nutrition (MEN) on mesenteric blood flow and oxygenation with Doppler USG and Near Infrared Spectroscopy (NIRS) during therapeutic hypothermia (TH) in babies with HIE.</p><p><strong>Methods: </strong>This prospective, randomized-controlled study was composed of infants receiving MEN (study group, n = 30) and infants who were not fed (control group, n = 30) during hypothermia. 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引用次数: 0
摘要
背景：我们的目的是通过多普勒 USG 和近红外光谱（NIRS）评估在治疗性低温（TH）期间最小肠内营养（MEN）对 HIE 婴儿肠系膜血流和氧合的影响：这项前瞻性随机对照研究包括在低体温期间接受 MEN 的婴儿（研究组，n = 30）和不喂养的婴儿（对照组，n = 30）。在喂养前后，用近红外光谱对婴儿进行连续监测，并用多普勒超声波测量肠系膜血流速度：研究组和对照组的平均胎龄和出生体重分别为 38.73 ± 1.5-39.09 ± 1.02 周和 3076 ± 280.4-3295 ± 391 克。研究组婴儿达到完全肠内营养的时间和住院时间明显更短（p = 0.049，p = 0.016）。研究组婴儿出现喂养不耐受的情况较少（p = 0.006）。两组婴儿均未发生坏死性小肠结肠炎（NEC）。在 TH 和正常体温下，喂养前和喂养后的大脑 rSO2 测量结果无差异。在我们的研究中，我们观察到正常体温期间的 MEN 不会导致大脑和肠系膜氧合发生显著变化。虽然我们没有观察到血流和氧合的增加，但研究组中没有出现 NEC，喂养不耐受的发生率也较低，这可能表明在 TH 期间喂养是安全可行的：影响：TH 治疗期间的喂养不会导致大脑和肠系膜氧合发生显著变化。这是第一项同时使用多普勒 USG 和近红外成像技术评估 TH 期间 MEN 对缺氧缺血性脑病婴儿肠系膜氧合和血流速度影响的研究。在缺氧缺血性脑病期间进行 MEN 可能是安全可行的。
The effects of nutrition on mesenteric oxygenation among neonates with neonatal encephalopathy: a randomized clinical trial.
Background: We aimed to evaluate the effects of minimal enteral nutrition (MEN) on mesenteric blood flow and oxygenation with Doppler USG and Near Infrared Spectroscopy (NIRS) during therapeutic hypothermia (TH) in babies with HIE.
Methods: This prospective, randomized-controlled study was composed of infants receiving MEN (study group, n = 30) and infants who were not fed (control group, n = 30) during hypothermia. Infants were monitored continuously with NIRS and mesenteric blood flow velocities were measured with Doppler USG before and after feeding.
Results: The mean gestational age and birth weight for the study and control group were 38.73 ± 1.5-39.09 ± 1.02 weeks and 3076 ± 280.4-3295 ± 391 grams, respectively. Time to reach full enteral nutrition and hospital stay were significantly shorter in the study group (p = 0.049, p = 0.016). Infants in the study group experienced less feeding intolerance (p = 0.006). No infant developed necrotizing enterocolitis (NEC) in both groups. No difference was determined in pre- and post-feeding cerebral rSO2 measurements during TH and normothermia. Mesenteric rSO2, CSOR, and mesenteric blood flow measurements in the study group during normothermia were significantly increased, respectively (p = 0.03, p < 0.01, p < 0.01).
Conclusion: In our study, we observed that MEN during TH does not lead to a significant change in cerebral and mesenteric oxygenation. Although we did not observe an increase in blood flow and oxygenation, the absence of NEC and a lower incidence of feeding intolerance in the study group may suggest that feeding during TH is safe and feasible.
Impact: MEN during TH treatment does not lead to a significant change in cerebral and mesenteric oxygenation. This is the first study evaluating the effects of MEN on mesenteric oxygenation and blood flow velocities in infants with hypoxic-ischemic encephalopathy during TH with Doppler USG and NIRS, concomitantly. MEN during TH may be safe and feasible.
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Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and
disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques
relevant to developmental biology and medicine are acceptable, as are translational human studies
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