Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy
Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy
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DOI：
10.1159/000487848
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发表时间：
2018-01-01
期刊：
影响因子：
2.5
通讯作者：
Weiss, Michael D.
中科院分区：
文献类型：
--
作者：
Chang, Lilly L.;Wynn, James L.;Weiss, Michael D.
背景：体温过低期间停止肠内喂养缺乏支持证据。目的：我们的目的是确定缺氧缺血性脑病患者低温期间的最低限度肠内营养（MEN）是否与肠外营养持续时间、完全口服喂养时间和住院时间缩短相关，但与全身炎症或喂养并发症增加无关。方法：我们于 2012 年 12 月至 2016 年 5 月在佛罗里达州新生儿神经网络内进行了一项试点、回顾性匹配病例对照研究，研究对象为在低温期间接受 MEN 的患者 (n = 17) 与未进食的患者 (n = 17)。比较了住院时间、喂养相关结果以及 MRI 确定的脑损伤。通过多重测定在出生后 0-6、24 和 96 小时测量血清炎症介质，使用 Barkovich 系统对 MRI 进行评分。结果：MEN 受试者的住院时间缩短（平均 15 +/- 11 对比 24 +/- 19 天，p < 0.05），接受肠外营养的天数缩短（7 +/- 2 对比 11 +/- 6，p < 0.05），以及完全口服喂养的时间（8 +/- 5 对比 18 +/- 18，p < 0.05）。 MEN 与 24 小时和 96 小时血清 IL-12p70 显着降低相关 (p < 0,05)，脑 MRI 评分在组间没有显着差异。结论：低温期间的 MEN 与住院时间和完全喂养时间缩短相关，但不会增加喂养并发症或全身炎症。 (C) 2018 S Karger AG，巴塞尔
Background: Withholding enteral feedings during hypothermia lacks supporting evidence. Objectives: We aimed to determine if minimal enteral nutrition (MEN) during hypothermia in patients with hypoxic-ischernic encephalopathy was associated with a reduced duration of parenteral nutrition, time to full oral feeds, and length of stay, but would not be associated with increased systemic inflammation or feeding complications. Methods: We performed a pilot, retrospective, matched case-control study within the Florida Neonatal Neurologic Network from December 2012 to May 2016 of patients who received MEN during hypothermia (n = 17) versus those who were not fed (n = 17). Length of stay, feeding-related outcomes, and brain injury identified by MRI were compared. Serum inflammatory mediators were measured at 0-6, 24, and 96 h of life by multiplex assay, MRI were scored using the Barkovich system. Results: MEN subjects had a reduced length of hospital stay (mean 15 +/- 11 vs. 24 +/- 19 days, p < 0.05), days receiving parenteral nutrition (7 +/- 2 vs. 11 +/- 6, p < 0.05), and time to full oral feeds (8 +/- 5 vs. 18 +/- 18, p < 0.05). MEN was associated with a significantly reduced serum IL-12p70 at 24 and 96 h (p < 0,05), Brain MRI scores were not significantly different between groups. Conclusion: MEN during hypothermia was associated with a reduced length of stay and time to full feeds, but did not increase feeding complications or systemic inflammation. (C) 2018 S Karger AG, Basel