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The effects of nutrition on mesenteric oxygenation among neonates with neonatal encephalopathy: a randomized clinical trial

Abstract

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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Fig. 1
Fig. 2
Fig. 3: SMA and MCA blood flow measurements of groups before and after feeding during TH and normothermia.
Fig. 4: rSO2 measurements of groups before and after feeding during TH and normothermia.

Data availability

The data sets generated during and/or analyzed during current study may be available from the corresponding author on reasonable request.

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Funding

This study is funded by “Turkish Neonatal Society Investigator Award Grant”.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey

    Didem Arman, Serdar Cömert, Nursu Kara, Adem Gül & Kudret Ebru Erol

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  1. Didem Arman
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Didem Arman conceptualized and designed the review, conducted all statistical analysis, contributed to the interpretation of results, and drafted the manuscript; Nursu Kara participated in collecting data; Adem Gul participated in collecting data, and searched literature; Kudret Ebru Erol participated in collecting data, and searched literature; Serdar Comert conceptualized and designed the review, oversaw record screening and data extraction, contributed to interpretation of results, and reviewed; and all authors approved the final manuscript for submission.

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Correspondence to
Didem Arman.

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The authors declare no competing interests.

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Participation of infants was approved by the Institutional Review Board (IRB) of Istanbul Research and Training Hospital. Written informed consent was obtained from the parents of each participant in the study

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CONSORT 2010 Checklist

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Arman, D., Cömert, S., Kara, N. et al. The effects of nutrition on mesenteric oxygenation among neonates with neonatal encephalopathy: a randomized clinical trial.
Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03648-9

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  • Received: 14 May 2024

  • Revised: 20 August 2024

  • Accepted: 23 September 2024

  • Published: 20 October 2024

  • DOI: https://doi.org/10.1038/s41390-024-03648-9

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