Evaluation of the effect of umbilical vein catheter on splanchnic oxygenation in preterm babies with near infrared spectroscopy

Umbilical vein catheter (UVC) is frequently placed in preterm babies. Splanchnic circulation is a complex system. We have little quantitative information about intestinal oxygenation, digestion and absorption, and protection of mucosal structure in preterm babies. This study aimed to assess the impact of umbilical vein catheter (UVC) placement on splanchnic oxygenation in preterm infants. In our single-centre, prospective, observational cohort study, near-infrared spectroscopy probes were placed to monitor regional splanchnic oxygen saturation (rSO2S) and calculate fractional tissue oxygen extraction (FOE) in preterm infants (GA < 34 weeks, BW <2000 g) for one-week post-stabilization. Gestational age-matched UVC (+) and (-) Groups were clinically and physiologically compared, before and after UVC placement/removal. Out of the participants, 23 infants were in the UVC (+) Group, while 25 infants were in the UVC (-) Group. The UVC (+) Group showed delayed feeding initiation, full enteral feeding, longer parenteral nutrition, and hospitalization compared to the UVC (-) Group. The incidence of feeding intolerance and necrotizing enterocolitis, as well as rSO2S and FOE, did not significantly differ between the groups on a daily basis. rSO2S measurements of babies with feeding intolerance were found to be lower than those without. In the UVK (+) group, the mean rSO2S of SGA babies was lower than that of AGA babies.According to the results of our study, no negative effect of UVC on splanchnic oxygenation was detected. We believe that further research is needed to understand the adverse effects of the UVC through mechanisms such as mechanical obstruction, splanchnic venous congestion, or inflammation, due to the more frequent observation of feeding intolerance while the catheter is in place in the UVC (+) Group.