Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants
Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants
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对患病极低出生体重婴儿进行积极营养治疗的随机对照试验
DOI：
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
J. Dodge
中科院分区：
文献类型：
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作者：
D. Wilson;P. Cairns;H. Halliday;Mark Reid;G. Mcclure;J. Dodge
目的改善极低出生体重儿（VLBW）的能量摄入，减少生长问题，减少肺部发病率，缩短住院时间，避免可能的喂养相关的发病率。认为与肠外和肠内喂养相关的极低出生体重婴儿的发病包括支气管肺发育不良、坏死性小肠结肠炎、败血症、胆汁淤积和早产儿骨质减少。方法：一项前瞻性随机对照试验（RCT）比较了两种类型的营养干预，涉及125名患病VLBW婴儿在区域新生儿重症监护室的设置。婴儿被随机分配到积极的营养方案（A组）或对照组（B组）。B组给予保守的营养方案，而A组给予更积极的肠外和肠内营养。采用Student检验、Mann-Whitney U检验、χ2检验和逻辑回归进行统计学分析。结果A组中有更多的病情较重的婴儿，如初始疾病严重程度（P <0.01），但平均总能量摄入量显着较高（P <0.001），在第3至42天，A组接受全或部分肠外营养。两组的生存率和支气管肺发育不良、败血症、胆汁淤积、骨质减少和坏死性小肠结肠炎的发生率相似。A组婴儿在生命早期和出院时的生长明显更好。肺部发病率或住院时间没有减少。结论在不增加不良临床或代谢后遗症风险的情况下，可以改善患病极低出生体重儿的营养摄入。改善营养摄入导致更好的生长，在新生儿早期和出院时，但没有减少肺部发病率或缩短住院时间。
AIMS To improve energy intake in sick very low birthweight (VLBW) infants; to decrease growth problems, lessen pulmonary morbidity, shorten hospital stay, and avoid possible feeding related morbidity. Morbidity in VLBW infants thought to be associated with parenteral and enteral feeding includes bronchopulmonary dysplasia, necrotising enterocolitis, septicaemia, cholestasis and osteopenia of prematurity. METHODS A prospective randomised controlled trial (RCT) comparing two types of nutritional intervention was performed involving 125 sick VLBW infants in the setting of a regional neonatal intensive care unit. Babies were randomly allocated to either an aggressive nutritional regimen (group A) or a control group (group B). Babies in group B received a conservative nutritional regimen while group A received a package of more aggressive parenteral and enteral nutrition. Statistical analysis was done using Student’st test, the Mann-Whitney U test, the χ2 test and logistic regression. RESULTS There was an excess of sicker babies in group A, as measured by initial disease severity (P <0.01), but mean total energy intakes were significantly higher (P <0.001) in group A at days 3 to 42 while receiving total or partial parenteral nutrition. Survival and the incidences of bronchopulmonary dysplasia, septicaemia, cholestasis, osteopenia and necrotising enterocolitis were similar in both groups. Growth in early life and at discharge from hospital was significantly better in babies in group A. There were no decreases in pulmonary morbidity or hospital stay. CONCLUSION Nutritional intake in sick VLBW infants can be improved without increasing the risk of adverse clinical or metabolic sequelae. Improved nutritional intake resulted in better growth, both in the early neonatal period and at hospital discharge, but did not decrease pulmonary morbidity or shorten hospital stay.
早产儿使用的静脉脂肪乳剂中含有有毒氢过氧化物。
影响因子：
8
作者：
Helbock,HJ;Motchnik,PA;Ames,BN
通讯作者：
Ames,BN
早期少量喂养可促进危重早产儿的生长。
DOI：
10.1159/000244160
发表时间：
1995
期刊：
Biology of the neonate
影响因子：
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作者：
Troche,B;Harvey-Wilkes,K;Engle,WD;Nielsen,HC;Frantz3rd,ID;Mitchell,ML;Hermos,RJ
通讯作者：
Hermos,RJ