Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants.
| Autor: | Dinerstein A; Department of Neonatology, Hospital Sarda, Buenos Aires, Argentina. alejandro.dinerstein@gmail.com, Nieto RM, Solana CL, Perez GP, Otheguy LE, Larguia AM |
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| Jazyk: | angličtina |
| Zdroj: | Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2006 Jul; Vol. 26 (7), pp. 436-42. |
| DOI: | 10.1038/sj.jp.7211539 |
| Abstrakt: | Objective: To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time. Methods: An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni- and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed. Results: Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17-0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P < 0.001). Conclusions: Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age. |
| Databáze: | MEDLINE |
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