Strategies to improve feeding tolerance in preterm infants
Strategies to improve feeding tolerance in preterm infants
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DOI：
10.3109/14767058.2012.715021
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发表时间：
2012-10-01
影响因子：
1.8
通讯作者：
Fanaro, Silvia
中科院分区：
文献类型：
--
作者：
Fanaro, Silvia
出生后生长受限和发育不良是早产儿的一个主要问题，特别是极低出生体重的婴儿。因此，在不增加坏死性小肠结肠炎(NEC)风险的情况下优化肠内营养已成为新生儿医生的优先事项，他们经常面临解释常见和非特异性喂养不耐受(FI)迹象的临床和预后意义的挑战。新生儿医生经常开出肠内营养处方，就像在达到完全肠内喂养的目的和对NEC的恐惧之间走钢丝一样。尽管在新生儿重症监护方面取得了进展，但NEC仍然是极低出生体重婴儿死亡率(15%-30%)和发病率的主要原因之一。然而，FI和NEC之间的关系仍不清楚。喂养不耐受往往导致停止肠道喂养、延迟达到完全肠道喂养和延长住院时间。旨在预防和/或治疗喂养不耐受的战略多种多样，并不总是得到科学证据的支持。
Postnatal growth restriction and failure to thrive is a major issue in preterm, especially extremely low-birth-weight infants. Optimization of enteral nutrition, without increasing the risk of necrotizing enterocolitis (NEC), has thus become a priority for the neonatologist, who often has to face the challenge of interpreting the clinical and prognostic significance of common and aspecific signs of feeding intolerance (FI). The neonatologist often prescribes enteral nutrition as if walking on a tightrope between the purposed attainment of full enteral feeding and the fear of NEC. Despite advances in neonatal intensive care, NEC still remains one of the leading causes of mortality (15-30%) and morbidity in very-low-birth-weight infants. However, the relationship between FI and NEC remains unknown. Feeding intolerance often leads to discontinuation of enteral feeds, delayed attainment of full enteral feeding and prolongation of hospitalization. Strategies aimed at preventing and/or treating episodes of feeding intolerance are diverse and not always supported by scientific evidence.