Early minimal feedings promote growth in critically ill premature infants.
Early minimal feedings promote growth in critically ill premature infants.
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早期少量喂养可促进危重早产儿的生长。
DOI：
10.1159/000244160
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Hermos,RJ
中科院分区：
文献类型：
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作者：
Troche,B;Harvey-Wilkes,K;Engle,WD;Nielsen,HC;Frantz3rd,ID;Mitchell,ML;Hermos,RJ
需要机械通气和脐动脉导管的危重早产儿在其疾病的急性期通常不接受肠内喂养。我们在一项前瞻性、对照和随机研究中研究了在此期间早期最小肠内喂养的安全性和益处。29名婴儿被随机分配到仅接受标准静脉输液和营养（NPO组，n = 13），或从24 h开始接受小容量低热量持续喂养（1 ml/kg/h）（早期喂养组，n = 16）。两组患者在疾病急性期消退后开始标准肠内喂养，并按方案进行。两组的出生体重、胎龄和Apgar评分相似。喂养不耐受的发生率没有显著差异。NPO组的两名婴儿出现坏死性小肠结肠炎的临床体征。每周测量血清二胺氧化酶和生长调节素C，直到30-60日龄，两组之间没有差异。早期喂养组达到120 ml/kg/d肠内摄入量所需的天数更少（早期喂养组10 ± 3 d，NPO组13 ± 4 d; p < 0.05）。出生后30天，早期喂养组比出生体重高223 ± 125 g，而NPO组比出生体重高95 ± 161 g（p < 0.05）。第6天至第30天的平均摄入量（kcal/kg/天）在两组之间无差异。我们的结论是，需要机械通气的极低出生体重危重儿早期最低喂养耐受性良好，并导致减少时间达到120 ml/kg/天的肠内喂养，并在生命的第30天增加更大的体重。
Critically ill premature infants requiring mechanical ventilation and an umbilical artery catheter usually do not receive enteral feedings during the acute phase of their illness. We studied the safety and benefit of early minimal enteral feedings during this time in a prospective, controlled, and randomized study. Twenty-nine infants were randomly assigned to receive only standard intravenous fluid and nutrition (nothing per OS, NPO group; n = 13), or in addition to receive small-volume hypocaloric continuous feedings (1 ml/kg/h), beginning at 24 h of age (early-feeding group; n = 16). Standard enteral feedings were begun in both groups at the resolution of the acute phase of the illness and advanced by protocol. The two groups were of comparable birth weight, gestational age, and Apgar scores. There were no significant differences in the episodes of feeding intolerance. Two infants in the NPO group developed clinical signs of necrotizing enterocolitis. Serum diamine oxidase and somatomedin C were measured weekly until 30-60 days of age and were not different between the two groups. The early-feeding group required fewer days to reach 120 ml/kg/day enteral intake (early-feeding group 10 + 3 days, NPO group 13 ± 4 days; p < 0.05). On day 30 of life the early-feeding group was 223 ± 125 g above birth weight, while the NPO group was 95 ± 161 g above birth weight (p < 0.05). The average intake (kcal/kg/day) from day 6 to day 30 was not different between the two groups. We conclude that early minimal feedings in critically ill very-low-birth-weight infants requiring mechanical ventilation are well tolerated and result in reduced time to reach 120 ml/kg/day of enteral feeding and in a greater weight gain by day 30 of life.