title: Splanchnic tissue oxygenation, but not brain tissue oxygenation, increases after feeds in stable preterm neonates tolerating full bolus orogastric feeding.
abstract: OBJECTIVE
  The objective of this prospective, observational study was to test the hypothesis that tissue oxygenation in the splanchnic bed compared with tissue oxygenation in the cerebral circulation changes after feeding in preterm neonates who are tolerating full bolus orogastric feeds.
  
  
  METHODS
  Clinically stable premature neonates with postmenstrual age between 32 and 35(6/7) weeks who were tolerating full bolus feedings were studied before feeding and 1 h after feeding using near-infrared spectroscopy. The ratio of oxygenated to reduced hemoglobin (tissue oxygenation index, TOI) in the splanchnic circulation bed was divided by the TOI in the cerebral circulation, thereby yielding the cerebro-splanchnic oxygenation ratio (CSOR). We compared TOI and CSOR before and after feeding. As the changes in TOI and CSOR had non-Gaussian distribution, nonparametric statistics were used.
  
  
  RESULTS
  Among 32 infants, CSOR increased significantly after feeding (median difference 0.08; range -0.48, +0.58; P=0.011), whereas pulse oximetry did not change significantly (P=0.600). The change in CSOR with feeding was associated with a significant increase in splanchnic TOI (preprandial median 43.8, range 25.2-68.4 vs postprandial 47.5, range 25.8-70.8; P=0.013), without any significant change in brain TOI (preprandial median 64.9, range 44.5-75.4 vs postprandial 58.9, range 42.2-72.3; P=0.153).
  
  
  CONCLUSIONS
  This study indicates that CSOR and splanchnic TOI, but not brain TOI, increase significantly after feeding in stable preterm infants who are tolerating full orogastric feeds.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY 10461, USA.
authors.forename: V
authors.initials: V
authors.lastname: Dave
authors.forename: L P
authors.initials: LP
authors.lastname: Brion
authors.forename: D E
authors.initials: DE
authors.lastname: Campbell
authors.forename: M
authors.initials: M
authors.lastname: Scheiner
authors.forename: C
authors.initials: C
authors.lastname: Raab
authors.forename: S M
authors.initials: SM
authors.lastname: Nafday
mesh_terms: D001784:Blood Gas Analysis; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015331:Cohort Studies; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D010108:Oxyhemoglobins / Q000378:metabolism*; D019518:Postprandial Period / Q000502:physiology*; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D013152:Splanchnic Circulation / Q000502:physiology*
chemical_list: D010108:Oxyhemoglobins; D010100:Oxygen