NUTRITIONAL MANAGEMENT OF INFANTS WITH BRONCHOPULMONARY DYSPLASIA (BPD): EFFE

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 支气管肺发育不良（BPD）影响大约四分之一的极低出生体重儿（VLBW），并导致慢性肺部后遗症和生长发育受损的可能性。虽然躯体生长与肺功能改善有关，但这种疾病的管理通常包括限制液体以最大限度地减少肺水肿。当液体受到限制时，最大限度地增加营养摄入的最佳方法以及增加热量密度（高于24 kcal/oz）对生长，钙代谢和骨矿物质状态的影响尚不清楚。 尽管摄入量有限，但向BPD进展的VLBW婴儿提供早产婴儿配方奶粉或强化至27 kcal/oz（0.9 kcal/mL）的人乳6周，将导致婴儿的钙吸收、骨骼和身体生长与无BPD且喂食更高体积的强化人乳或24 kcal/oz（0.8 kcal/mL）配方奶粉的婴儿相当。这些结果将支持在BPD婴儿中使用高热量密度喂养，以实现接近子宫内可实现的骨骼和总体生长结果。每组的体重增加平均为15-20 g/kg/d，与预期一致，平均身长（1.0 cm/周）和头围（0.8 cm/周）在子宫内水平也将类似地增加。 主要目的：比较不同喂养策略对伴有和不伴有支气管肺发育不良（BPD）的极低出生体重（VLBW）婴儿钙吸收的影响。 次要目的：评价住院期间提供120 kcal/kg/d喂养的VLBW婴儿的生长和身体组成。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Bronchopulmonary Dysplasia (BPD) affects approximately one-fourth of very low birth weight infants (VLBW) and results in chronic pulmonary sequelae and the potential for impaired growth and development. Although somatic growth is associated with improved lung function, management of this disorder frequently includes fluid restriction to minimize pulmonary edema. The optimal way to maximize nutritional intake when fluid is restricted and the effects of the common practice of increasing caloric density (above 24 kcal/oz) on growth, calcium metabolism and bone mineral status are unknown. Despite restricted volume intake, providing either preterm formula or human milk fortified to 27 kcal/oz (0.9 kcal/mL) for 6 weeks to VLBW infants with evolving BPD will lead to calcium absorption, bone and somatic growth in infants comparable to infants who do not have BPD and are fed higher volumes of fortified human milk or formula at 24 kcal/oz (0.8 kcal/mL). These results will support the use of high caloric density feedings in infants with BPD to achieve both bone and overall growth outcomes close to those achievable in utero. Weight gain in each group will average 15-20 g/kg/d, consistent with expectations and mean length (1.0 cm/wk) and head circumference (0.8 cm/wk) will similarly increase at in utero levels. Primary Aim: To compare the effects of different feeding strategies on calcium absorption in Very Low Birth Weight (VLBW) infants with and without evolving bronchopulmonary dysplasia (BPD). Secondary Aim: To evaluate growth and body composition in VLBW infants provided 120 kcal/kg/d feeding during hospitalization.