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PEDIATRICS Vol. 105 No. 2 February 2000, pp. 350-353

Changes in Mesenteric Blood Flow Response to Feeding: Conventional Versus Fiber-optic Phototherapy

Received Mar 16, 1999; accepted Jun 11, 1999.

Marco Pezzati*, Roberto BiagiottiDagger , Venturella Vangi*, Enrico Lombardi*, Lisa Wiechmann*, and Firmino F. Rubaltelli*

From the * Department of Pediatrics, Division of Neonatology, University of Firenze School of Medicine, Firenze, Italy; and the Dagger  Department of Obstetrics and Gynecology, University of Firenze School of Medicine, Firenze, Italy.

Objective.  To evaluate whether fiberoptic phototherapy influences the postprandial increase in mesenteric blood flow velocity similarly to conventional phototherapy in preterm infants.

Patients and Methods.  With the use of Doppler color ultrasonography, blood flow velocity in the superior mesenteric artery was measured both preprandially and postprandially in 19 preterm infants during and after conventional phototherapy, and in 20 preterm infants during and after fiber-optic phototherapy. The mean arterial blood pressure/mean flow velocity ratio was calculated as an estimate of relative vascular resistance of the superior mesenteric artery.

Results.  The study shows that conventional phototherapy blunts the postprandial mesenteric blood flow response to feeding in preterm infants. Furthermore, it shows that the postprandial increase in intestinal blood flow is not attenuated when fiber-optic phototherapy is administered, and that such postprandial increase of blood flow is significantly greater than in infants receiving conventional phototherapy. During and after fiber-optic phototherapy, a significant reduction in postprandial relative vascular resistance was found; such reduction was significantly greater than during conventional phototherapy.

Conclusions.  Fiber-optic phototherapy is preferable to conventional phototherapy for the treatment of hyperbilirubinemia in preterm infants because it does not affect the physiologic postprandial redistribution of blood flow from the periphery to the gastrointestinal system as does conventional phototherapy.  Key words:  conventional phototherapy, fiber-optic phototherapy, mesenteric blood flow velocity, newborn.


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