A Randomized Trial of an Exclusive Human Milk Diet in Neonates with Single Ventricle Physiology

Autor: Cynthia, Blanco, Amy, Hair, Lindsey B, Justice, Dantin, Roddy, Krista, Bonagurio, Patricia K, Williams, Desiree, Machado, Bradley S, Marino, Annie, Chi, Cheryl, Takao, Erin, Gordon, Amir, Ashrafi, Nicole, Cacho, Jay D, Pruetz, John M, Costello, David S, Cooper
Rok vydání: 2023
Předmět:
Zdroj: The Journal of Pediatrics. 256:105-112.e4
ISSN: 0022-3476
DOI: 10.1016/j.jpeds.2022.11.043
Popis: To determine whether weight gain velocity (g/kg/day) 30 days after initiation of feeds following cardiac surgery and other clinical outcomes improve in infants with single ventricle physiology fed an exclusive human milk diet compared with a mixed human and bovine diet.In this multicenter, randomized, single blinded, controlled trial, term neonates ≤7 days of age with SVP and anticipated cardiac surgical palliation within 30 days of birth were enrolled at 10 US centers. Both groups received human milk if fed preoperatively. During the 30 days after feeds were started postoperatively, infants in the intervention group () received human milk fortified once enteral intake reached 60 mL/kg/day with a human milk-based fortifier designed for term neonates. The control group received standard fortification with formula once enteral intake reached 100 mL/kg/day. Perioperative feeding and parenteral nutrition study algorithms were followed.107 neonates were enrolled (EHM=55, control=52). Baseline demographics and characteristics were similar between groups. Median weight gain velocity at study completion was higher in EHM vs control group (25 [IQR, 11-43] vs 17 [2-26] g/day, respectively; p=0.008). Other growth measures were similar between groups. Necrotizing enterocolitis of all Bell stages was higher in the control group (15.4 % vs 3.6%, respectively, p=0.04). Incidence of other major morbidities, surgical complications, length of hospital stay, and hospital mortality were similar between groups.Neonates with SVP have improved short-term growth and decreased risk of NEC when receiving an exclusive human milk diet following stage 1 surgical palliation.
Databáze: OpenAIRE
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