Changes in Cerebral and Splanchnic Tissue Oxygenation During Enteral Feeding in Premature Infants with Duct-Dependent Congenital Heart Disease

Abstract

Introduction

This study aims to compare cerebral and splanchnic regional oxygen saturation(rSO2) in premature infants with duct-dependent congenital heart disease (CHD) using near-infrared spectroscopy (NIRS) with that of case-control premature infants without CHD.

Materials and Methods

Premature infants with duct-dependent CHD requiring prostaglandin E1 (PGE1) for more than 10 days and control preterm infants (without CHD) were monitored for 36 hours using NIRS to assess cerebral and splanchnic rSO2. Both groups received gavage enteral feeding. Multiple measurements were taken around feeding at three different times (30 minutes before, during, and 30 minutes after feeding).

Results

A total of 16 cases were included in the study (8 CHD and 8 controls). The CHD infants had the following diagnoses: four with aortic coarctation, two with interrupted aortic arch, one with hypoplastic left heart syndrome, and one with D-transposition of the great arteries. The median gestational age (35 weeks in duct-dependent CHD vs. 34 weeks in controls) and birth weight (1850 g vs. 1800 g, respectively) were similar between the two groups (p>0.05). The median cerebral NIRS measurements in the controls were 12 points higher than in the cases (P=0.03), and the splanchnic NIRS measurements were 20 points higher (P=0.01). The median cerebral NIRS measurements in the cases were 60%, 64%, and 62% at baseline, during feeding, and post-feeding, respectively, while the controls had values of 72%, 74%, and 71% at the same times. The median splanchnic NIRS measurements in the cases were 30%, 35%, and 38% at baseline, during feeding, and post-feeding, respectively, while the controls had values of 50%, 52%, and 54%. Similar changes in cerebral and splanchnic NIRS values were observed during feeding in both the cases and controls (p>0.05).

Conclusion

Premature neonates with duct-dependent CHD have a reduction in both cerebral and splanchnic rSO2 values when compared to age-matched controls. NIRS monitoring demonstrated lower regional oxygen saturation levels in duct-dependent CHD infants compared with controls, suggesting reduced tissue oxygenation during feeding. Further studies with larger sample sizes are needed in this area.

Keywords

premature - congenital heart disease - cerebral oxygenation - splanchnic oxygenation

Publication History

Received: 03 April 2025

Accepted after revision: 04 December 2025

Article published online:
09 January 2026

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