Early Total Enteral Feeding in Stable Very Low Birth Weight Infants: A Before and After Study
| Autor: | Ankita Goel, Piali Mandal, Amit Bishnoi, Arvind Saili, Sushma Nangia, Soumya Tiwari |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Enteral administration Sepsis 03 medical and health sciences 0302 clinical medicine Intravenous fluid Enteral Nutrition Enterocolitis Necrotizing 030225 pediatrics Antibiotic therapy Medicine Humans Infant Very Low Birth Weight 030212 general & internal medicine Prospective Studies business.industry Incidence (epidemiology) Incidence Infant Newborn Length of Stay medicine.disease Anti-Bacterial Agents Low birth weight Infectious Diseases Pediatrics Perinatology and Child Health Necrotizing enterocolitis Before and after study Female Parenteral Nutrition Total medicine.symptom business |
| Zdroj: | Journal of tropical pediatrics. 64(1) |
| ISSN: | 1465-3664 |
| Popis: | Background Fear of necrotizing enterocolitis (NEC) has perpetuated delayed initiation and slow advancement of enteral feeding in very low birth weight (VLBW) infants with inherent risks of parenteral alimentation. The objective of this study was to assess effect of early total enteral feeding (ETEF) on day of achievement of full enteral feeds, feed intolerance, NEC and sepsis. Methods In total, 208 stable VLBW neonates (28-34 weeks) admitted during 6 month periods of three consecutive years were enrolled. First phase (n = 73) constituted the 'before' phase with standard practice of initial intravenous fluid therapy and slow enteral feeding. The second prospective phase (n = 51) consisted of implementation of ETEF with infants receiving full enteral feeds as per day's fluid requirement since Day 1 of life. The third phase (n = 84) was chosen to assess the sustainability of change in practice. Results Day of achievement of full feeds was significantly earlier in Phases 2 and 3 compared with Phase 1 (8.97 and 5.47 vs. 14.44 days, respectively, p = 0.0001). Incidence of feed intolerance was comparable between Phases 1 and 2 (22 vs. 14%, p = 0.28), with marked reduction in incidence of NEC (14 vs. 4%, p = 0.028). There was a significant decrease in sepsis, duration of parenteral fluid and antibiotic therapy as well as hospital stay with comparable mortality. Conclusion In stable preterm VLBW infants, ETEF is safe and has the benefit of optimizing nutrition with decrease in sepsis, NEC and hospital stay. |
| Databáze: | OpenAIRE |
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