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

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 支气管肺发育不良(BPD)影响了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潜在的生长发育障碍。虽然躯体生长与肺功能的改善有关，但对这种疾病的治疗通常包括限制液体以最大限度地减少肺水肿。当液体受限时，最大限度地增加营养摄入量的最佳方式是什么，以及增加卡路里密度(高于24千卡/盎司)对生长、钙代谢和骨矿状况的影响尚不清楚。 尽管摄入量受到限制，但给BPD逐渐形成的极低出生体重儿提供早产配方奶粉或强化到27千卡/盎司(0.9千卡/毫升)的母乳6周，将导致婴儿的钙吸收、骨骼和躯体生长，与没有BPD并以24千卡/盎司(0.8千卡/毫升)喂食更高剂量强化母乳或配方奶的婴儿相当。这些结果将支持在患有BPD的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。每组的体重平均增加15-20g/kg/d，与预期一致，平均长度(1.0 cm/wk)和头围(0.8 cm/wk)在子宫内水平也将同样增加。 主要目的：比较不同喂养策略对伴有和不伴有进行性支气管肺发育不良(BPD)的极低出生体重儿(VLBW)钙吸收的影响。 第二目的：了解极低出生体重儿住院期间每天进食120kcal/kg时的生长发育和体成分。

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.