Nutritional Practices in the Neonatal Intensive Care Unit: Analysis of a 2006 Neonatal Nutrition Survey
Nutritional Practices in the Neonatal Intensive Care Unit: Analysis of a 2006 Neonatal Nutrition Survey
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DOI：
10.1542/peds.2007-3644
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发表时间：
2009-01-01
期刊：
影响因子：
8
通讯作者：
Georgieff, Michael K.
中科院分区：
文献类型：
--
作者：
Hans, Deborah M.;Pylipow, Mary;Georgieff, Michael K.
目标。这项调查的目的是确定目前对早产儿的肠外营养和肠内营养实践意图与已发表的建议和以前的喂养实践相比如何。方法：向NICU主任、新生儿团契主任、新生儿科医生、新生儿护士从业者和新生儿营养师发送了一份关于3个早产儿体重组的喂养策略的调查问卷。通过电子邮件和标准邮件服务分发的调查问卷共775份。结果共收到176份调查问卷(23%)。大多数从业者在生命的第一天就开始为极早产儿提供肠外营养。91%的受访者增加了每天的蛋白质摄入。大多数受访者以固定的速度增加脂肪供应，而不是基于甘油三酯水平。98%的单位使用胰岛素，但只有12%的单位使用胰岛素作为营养佐剂来增加体重。在所有出生体重类别中，第一次肠道喂养时最常见的是母乳。与过去相比，肠内喂养开始得更早，增加得也更快，特别是对于极低出生体重的婴儿(80%的受访者在所有体重类别中以每天10至20毫升/公斤的速度增加喂养。结论：临床医生报告说，他们比过去更早开始肠内营养和肠内营养，数量也比过去更大，反映出对早产儿最佳营养实践的了解增加。这些数据表明，早产儿持续的宫外发育失败并不是因为缺乏最佳的营养实践知识和意图。儿科2009；123：51-
OBJECTIVE. The goal of this investigation was to determine how current parenteral nutrition and enteral nutrition practice intentions for preterm infants compare with published recommendations and previous feeding practices.METHODS. A survey of feeding strategies for 3 preterm infant weight groups was sent to NICU directors, neonatal fellowship directors, neonatologists, neonatal nurse practitioners, and neonatal dieticians. A total of 775 surveys were distributed by both electronic and standard mail services.RESULTS. There were 176 survey responses (23%). The majority of practitioners initiated parenteral nutrition for very preterm infants in the first day of life. Ninety-one percent of respondents increased protein delivery daily. Most respondents increased lipid delivery at a fixed rate, rather than on the basis of triglyceride levels. Insulin was used in 98% of units, but only 12% of the time as a nutritional adjuvant to increase weight gain. Across all birth weight categories, breast milk was prescribed most commonly for the first enteral feeding. Enteral feedings were started earlier and increased faster than in the past, especially for extremely low birth weight infants (80% of respondents increased feedings at rates of 10 to 20 mL/kg per day across all weight categories.CONCLUSIONS. Clinicians reported that they are initiating parenteral and enteral nutrition earlier and in larger volumes than in the past, reflecting increased knowledge about best nutritional practices in very preterm neonates. The data suggest that the persistent extrauterine growth failure of preterm infants is not attributable to a lack of best nutritional practice knowledge and intention. Pediatrics 2009; 123: 51-