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Am J Perinatol 2024; 41(S 01): e2341-e2347
DOI: 10.1055/s-0043-1771257
Original Article

Oxygenation Instability during Bolus versus Continuous Feeding among Very Low Birth Weight Premature Infants, Supported by Noninvasive Ventilation: A Randomized Prospective Study

Liron Borenstein-Levin 
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
,
Ahmad Haj
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
,
Arieh Riskin
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
3   Neonatal Intensive Care Unit, Bnai Zion Medical Center, Haifa, Israel
,
Gil Dinur
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
,
Yoav Littner
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
,
Ori Hochwald
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
,
Amir Kugelman
1   Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
2   Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
› Author Affiliations Funding This study was supported by a grant from Materna Research Institute.
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Abstract

Objective This study aimed to compare oxygenation instability, as documented by the oxygen saturation (SpO2) histograms, during bolus (over 30 minutes) versus continuous (over 2 hours) feeding among very low birth weight (VLBW) premature infants, supported with noninvasive ventilation (NIV).

Study Design This was a randomized prospective study. VLBW infants supported with NIV received three consecutive feeds in a random order of bolus-continuous-bolus or continuous-bolus-continuous. During each feed, 30 minutes and 2 hours histograms were documented.

Results Twenty-four infants (birth weight [mean ± standard deviation, SD] 820 ± 168 g, gestational age [mean ± SD] 27.0 ± 1.6 weeks) were included in our study (12 infants started with bolus feeding and 12 with continuous feeding) and 72 histograms were obtained (36 during bolus feeding and 36 during continuous feeding). No differences in mean fraction of inspired oxygen (FiO2), and number of apnea events were observed between the two feeding modes. Oxygenation instability as assessed by time spent in different SpO2 ranges and histogram types (stable or unstable) was comparable during bolus and continuous feedings. Changing feeding mode from bolus to continuous or vice versa did not significantly change the oxygenation instability of the group, though individual infants did show a consistence response to feeding length changes.

Conclusion Among VLBW infants supported with NIV, oxygenation instability, as documented by SpO2 histograms, was comparable between bolus and continuous feedings. Individual infants may benefit from specific feeding length, and this can be easily demonstrated by the SpO2 histograms.

Key Points

  • Feeding length did not affect oxygenation instability of preterm infants on noninvasive respiratory Support.

  • Oxygen saturation histograms allow objective quantification of oxygenation instability at the bedside.

  • Individual infants benefit from specific feeding length, as demonstrated by SpO2 histograms.

Keywords

feeding - oxygen saturation histograms - oxygenation instability - noninvasive respiratory support - premature infant - tube feeding


Publication History

Received: 09 November 2022

Accepted: 16 June 2023

Article published online:
21 July 2023

© 2023. Thieme. All rights reserved.

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