Feasibility and Efficacy of Defatted Human Milk in the Treatment for Chylothorax After Cardiac Surgery in Infants
Feasibility and Efficacy of Defatted Human Milk in the Treatment for Chylothorax After Cardiac Surgery in Infants
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DOI：
10.1007/s00246-016-1393-8
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发表时间：
2016-08-01
影响因子：
1.6
通讯作者：
Zyblewski, Sinai C.
中科院分区：
文献类型：
--
作者：
Fogg, Kristi L.;DellaValle, Diane M.;Zyblewski, Sinai C.
乳糜胸是一种常见的儿童心胸外科手术后并发症。乳糜胸的医学营养治疗包括中链甘油三酸酯（MCT）配方和减少肠内长链甘油三酸酯摄入以减少乳糜产生。由于母乳中长链甘油三酯含量高，乳糜胸婴儿的饮食中通常不含母乳。然而，考虑到母乳的免疫特性，患有乳糜胸的婴幼儿可能会从母乳中受益，而不是母乳替代品。我们进行了一项回顾性队列研究，以描述脱脂母乳（DHM）治疗婴儿心脏手术后乳糜胸的可行性和有效性，并比较接受DHM（n = 14）与MCT配方奶粉（n = 21）治疗的婴儿之间的生长结局。DHM和MCT配方治疗组之间的死亡率或住院时间无差异。DHM治疗组出院时的年龄别体重z评分显著高于MCT配方奶粉组，中位z评分分别为-1（-2至0.5）和-1.5（-2至0）（p = 0.02）。在心脏手术后乳糜胸的婴儿中，DHM是一种安全可行的医学营养治疗，可能对改善营养和生长具有潜在益处。
Chylothorax is a well-described complication after cardiothoracic surgery in children. Medical nutritional therapy for chylothorax includes medium-chain triglyceride (MCT) formulas and reduction in enteral long-chain triglyceride intake to reduce chyle production. Human milk is usually eliminated from the diet of infants with chylothorax because of its high long-chain triglyceride content. However, given the immunologic properties of human milk, young infants with chylothorax may benefit from using human milk over human milk substitutes. We performed a retrospective cohort study to describe the feasibility and efficacy of defatted human milk (DHM) for the treatment for chylothorax in infants after cardiac surgery and to compare growth outcomes between infants treated with DHM (n = 14) versus MCT formula (n = 21). There were no differences in mortality or length of hospital stay between the DHM and MCT formula treatment groups. The DHM treatment group had a significantly higher weight-for-age z-score at hospital discharge compared to the MCT formula group with median z-scores of -1 (-2 to 0.5) and -1.5 (-2 to 0), respectively (p = 0.02). In infants with chylothorax after cardiac surgery, DHM is a safe and feasible medical nutritional treatment and may have potential benefits for improved nutrition and growth.