SPLANCHNIC OXYGENATION MEASUREMENT WITH NEAR INFRARED SPECTROSCOPY AS A PREDICTOR OF FEEDING TOLERANCE IN EXTREMELY PRETERM NEWBORNS RECEIVING FORTIFIED FEEDING (NIRSFI)
Introduction: Feeding intolerance (FI) is a frequent encounter in the very preterm infants. Important factors associated with FI that also could be used as early predictors for NEC are impaired intestinal microcirculation and splanchnic hypoperfusion. Near Infrared Spectroscopy (NIRS) can non-invasively and continuously monitor organ perfusion. Our aim is to investigate changes in splanchnic regional oxygenation (srSO2) in extremely preterm newborns after HMb fortification.
Methods: NIRS probes will be placed on the preterm infants who reached full enteral nutrition and ready to start fortified feeds. NIRS recording will be started at least 30 minutes prior to the first fortified feeding (baseline time excluded) and continued for the next 24 hrs. We will review clinical data including: demographic (gestation age and weight) and nutritional data. We will follow up the clinical course to observe if they developed FI. Splanchnic Fractional Tissue Oxygen Extraction (sFTOE) and Splanchnic Cerebral Oxygenation Ratio (SCOR) will be calculated for all infants.
Results: Study question: Does splanchnic oxygenation measurement with NIRS could predict feeding intolerance after initiation of Human Milk based fortification in extremely preterm infants .The purpose of this study is to determine the splanchnic oxygenation parameters that predict risk of feeding intolerance in extremely preterm neonates. We will test the hypothesis that assessment of splanchnic oxygenation before and after initiation of fortification could predict feeding intolerance. Primary outcome: development of FI within 96 hours after initiation of fortification Decreased splanchnic oxygenation (srSO2 < 40%) will be considered as a cut-off for increased risk for FI Secondary outcomes: Splanchnic Fractional Tissue Oxygen Extraction (sFTOE) before and after fortification Splanchnic Cerebral Oxygenation Ratio (SCOR) before and after fortification Variability of srSO2 before and after fortification
Conclusion: Splanchnic oxygenation parameters can predict risk of feeding intolerance in extremely preterm neonates.