我们评估了针对极低出生体重(VLBW)婴儿的标准化营养计划对其营养和临床结局的影响。
这是对营养方案开始前后出生的VLBW婴儿的前瞻性分析。这个协议包括营养饲料,喂养进步,设防指南,肠外营养(PN)浓度的参数,以及PN线和中心线的中断。停止胃残留监测。用Fisher精确和Studentt检验进行统计分析。主要结局指标是接受PN的天数,喂养开始后,每个操作系统的天数为零(NPO),坏死性小肠结肠炎,和生长参数。次要结果指标是中心线天数,脓毒症,输血,胆汁淤积,骨质减少,慢性肺病,和早产儿视网膜病变.
分析了136名VLBW婴儿,包括方案前组77人和方案后组59人。研究方案后发现婴儿PN天数减少(26.1对[vs]18.4,P<0.01),喂养开始后产生NPO的天数较少(7.2vs4.0,P=.02),NEC(7.8%对0%,P=0.038),中线天数(26.5vs18.6,P<0.01),胆汁淤积(16%对3%,P=.02),和输血(5.3vs3.1,P=.028)。增长,由从出生到出院的z分数变化定义,体重改善(-1.3vs-0.8,P<0.01),长度(-1.5vs-1.0,P=0.033),和头部(-1.1vs-0.6,P=.024)。
针对VLBW婴儿的标准化营养倡议的启动显着改善了生长,减少PN使用,改善患者预后。
We assessed the impact of a standardized nutrition initiative for very low-birth-weight (VLBW) infants on their nutrition and clinical outcomes.
This was a prospective analysis of VLBW infants born before and after the initiation of a nutrition protocol. This protocol included trophic feeds, feeding advancement, fortification guidelines, parameters on the concentration of parenteral nutrition (PN), and the discontinuation of PN and central lines. Gastric residual monitoring was discontinued. Statistical analyses were performed with Fisher\'s exact and Student\'s t-tests. Primary outcome measures were days receiving PN, days made nil per os (NPO) after feeding initiation, necrotizing enterocolitis, and growth parameters. Secondary outcome measures were central-line days, sepsis, blood transfusions, cholestasis, osteopenia, chronic lung disease, and retinopathy of prematurity.
136 VLBW infants were analyzed, including 77 in the preprotocol group and 59 in the postprotocol group. Infants postprotocol were found to have reduced PN days (26.1 versus [vs] 18.4, P < .01), fewer days made NPO after feeding initiation (7.2 vs 4.0, P = .02), NEC (7.8% vs 0%, P = 0.038), central-line days (26.5 vs 18.6, P < .01), cholestasis (16% vs 3%, P = .02), and blood transfusions (5.3 vs 3.1, P = .028). Growth, defined by change in z-score from birth to discharge, improved for weight (-1.3 vs -0.8, P < .01), length (-1.5 vs -1.0, P = .033), and head (-1.1 vs -0.6, P = .024).
Initiation of a standardized nutrition initiative for VLBW infants significantly improved growth, reduced PN use, and improved patient outcomes.