THE RELATIONSHIP OF NEONATAL ALIMENTATION PRACTICES TO THE OCCURRENCE OF ENDEMIC NECROTIZING ENTEROCOLITIS
THE RELATIONSHIP OF NEONATAL ALIMENTATION PRACTICES TO THE OCCURRENCE OF ENDEMIC NECROTIZING ENTEROCOLITIS
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DOI：
10.1055/s-2007-999344
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发表时间：
1991-01-01
影响因子：
2
通讯作者：
KLIEGMAN, RM
中科院分区：
文献类型：
--
作者：
ANDERSON, DM;KLIEGMAN, RM
肠内营养是坏死性小肠结肠炎（NEC）发生的几个因素之一。 为了进一步研究这种关系，将19例NEC患者的营养记录与2例对照组的出生体重和入住重症监护室时间的患者进行比较。 比较的参数包括提供的液体总量、肠内喂养量推进速率、牛奶选择和给予的药物。 此外，由于大多数参数的平均值之间没有明显的每日差异，并且由于我们注意到配方奶粉摄入量和体积增量的明显波动，我们分析了两组之间的最大差异。 NEC患者的最大总液体摄入量发生在出生后第5天，为180.7 +/- 44 ml/kg。 对照组在同一天接受149.7 +/- 35 ml/kg（p < 0.01）。 NEC患者的最大肠内摄入量出现在第8天，为124.3 +/- 5.7 ml/kg，而对照组在该匹配日仅消耗83.5 +/- 60 ml/kg（p < 0.05）。 NEC患者从开始进食到最大进食日的进食增量率为27.8 +/-16 ml/kg/天，对照患者为16.8 +/-11 ml/kg/天（p < 0.0005）。 此外，在整个研究期间，与对照组相比，发生NEC的患者具有最大的1天增量（56.7 +/-19.4vs44.6 +/-26.2ml/kg，p < 0.05）。 过快的肠内喂养和过多的液体量可能使早产儿容易发生NEC，应予以劝阻。 我们建议低出生体重新生儿的每日奶量增量不应超过20 ml/kg/天。
Enteric alimentation has been one of several factors implicated in the development of necrotizing enterocolitis (NEC). To examine this relationship further, the alimentation records of 19 patients who developed NEC were each compared with two matched patients controlled for birthweight and time of admission to the intensive care nursery. Parameters compared included total fluids provided, rate of enteral feed volume advancement, milk selection, and medications given. In addition, because there were no marked day-to-day differences between the mean values of most parameters and because we noted a marked fluctuation of formula intake and volume increments, we analyzed the maximum differences between the two groups. Maximum total fluids intake occurred on day 5 of life for the NEC patients and was 180.7 +/- 44 ml/kg. The control group on this same day received 149.7 +/- 35 ml/kg (p < 0.01). Maximum enteral intake occurred on day 8 for the NEC patients at 124.3 +/- 5.7 ml/kg, whereas the control group had consumed only 83.5 +/- 60 ml/kg (p < 0.05) on this matched day. The feed increment rate from initiation of feeds to day of maximum feeds was 27.8 +/- 16 ml/kg/day for the NEC patients and 16.8 +/- 11 for the control patients (p < 0.0005). Furthermore, during the entire study period patients who developed NEC had the greatest 1 day increment compared with the controls (56.7 +/- 19.4 vs 44.6 +/- 26.2 ml/kg, p < 0.05). Very rapid advancement of enteral feedings and excessive fluid volumes may predispose premature infants to the development of NEC and should be discouraged. We recommend that daily milk volume increments should not exceed 20 ml/kg/day in low birthweight neonates.