ABSTRACT
OBJECTIVE: To measure the effect of nasal continuous positive airway pressure (CPAP) on intestinal blood flow velocity responses to enteral feedings and left ventricular output (LVO). STUDY DESIGN: Eighteen infants completed the study (birth weight 1793+/-350 g, gestational age 32.1+/-1.1 weeks). On the day infants were weaned from CPAP to room air, pre- and postprandial (0, 30, 60 and 90 min after feeding) mean velocity (MV), peak systolic velocity (PSV) and end diastolic velocity (EDV) were measured for one feeding given when receiving CPAP ('on CPAP'), and for one feeding given after CPAP had been discontinued ('off CPAP'). Preprandial LVO was measured before and after CPAP discontinuation. RESULT: MV and PSV were significantly lower when infants were on CPAP (P<0.05). Maximum postprandial MV, PSV and EDV occurred at 30 min when on CPAP and at 60 min when off CPAP. Preprandial LVO was similar when infants were on and off CPAP. CONCLUSION: CPAP administration affects pre- and postprandial intestinal blood flow velocity, which may impact tolerance to enteral feedings.
Subject(s)
Continuous Positive Airway Pressure , Enteral Nutrition , Intestines/blood supply , Postprandial Period/physiology , Birth Weight , Blood Flow Velocity/physiology , Cardiac Output/physiology , Female , Gastrointestinal Motility/physiology , Gestational Age , Humans , Image Processing, Computer-Assisted , Infant, Newborn , Male , Mesenteric Artery, Superior/diagnostic imaging , Prospective Studies , Ultrasonography, Doppler, Pulsed , Vascular Resistance/physiology , Ventricular Function, Left/physiologyABSTRACT
OBJECTIVE: To investigate the effects of umbilical artery catheters (UACs) on superior mesenteric artery (SMA) blood flow velocity (BFV) following enteral feedings in very low birth weight preterm infants. STUDY DESIGN: Very low birth weight preterm infants who had UACs inserted as part of standard clinical care were enrolled in this prospective study. On the day the UAC was scheduled to be removed, pre- and postprandial SMA BFV (mean, peak systolic and end diastolic velocities) were measured in conjunction with a minimal enteral feeding given while the UAC was in place. The same measurements were made with the next feeding given after the UAC was removed. Preprandial measurements were made at least 3 h after the last enteral feeding, and postprandial measurements were made 30, 45 and 60 min after the feeding began. The same volume and type of feeding were used for both studies. RESULTS: The birth weight and gestational age of the 19 infants who completed the study were 1014+/-221 g and 27.4+/-1.9 weeks, respectively. Infants were 4.6+/-1.7-days-old when the first SMA BFV measurement was made, the volume of enteral feedings was 1.3+/-0.6 ml, and the time between the two enteral feedings was 4.7+/-3.2 h. Preprandial SMA BFV did not differ with the UAC in place compared with the UAC removed. Peak postprandial velocities were at 45 min after feedings began. The percent increase from baseline was not significantly different with the UAC in place compared with the UAC removed. CONCLUSIONS: Preprandial SMA BFV and postprandial SMA BFV responses to minimal enteral feedings were not affected by the presence of a UAC.
