Abstract :
Keywords Phototherapy; Splanchnic oxygenation; Near infrared spectroscopy; Feeding intolerance Highlights * We measured regional splanchnic oxygenation during phototherapy. * Splanchnic oxygenation decreased and blood oxygen extraction increased. * Peripheral vasodilation and redistribution of blood flow may explain this effect. * These results help explain association between phototherapy and feeding intolerance. Abstract 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.sub.2S) 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.sub.2S), oxygen extraction fraction (FOES), and cerebrosplanchnic oxygenation ratio (CSOR) were recorded before, during, and after PT discontinuation. Results During PT rSO.sub.2S 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. Abbreviations ABE, Acute bilirubin encephalopathy; CSOR, Cerebrosplanchnic oxygenation ratio; FOEC, Cerebral oxygen extraction fraction; FOES, Splanchnic oxygen extraction fraction; KSD, Kernicterus spectrum disorders; NIRS, Near infrared spectroscopy; PT, Phototherapy; rSO.sub.2C, Cerebral regional oxygenation; rSO.sub.2S, Splanchnic regional oxygenation; TSB, Total serum bilirubin Author Affiliation: (a) Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy (b) Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy * Corresponding author at: Division of Neonatology, Careggi University Hospital, Largo Brambilla, 3, 50141 Florence, Italy. Article History: Received 16 July 2022; Revised 27 August 2022; Accepted 29 August 2022 Byline: Carlo Dani [carlo.dani@unifi.it] (a,b,*), Martina Ciarcià (a), Francesca Miselli (a), Michele Luzzati (a), Chiara Petrolini (a), Iuri Corsini (a), Simone Pratesi (a)