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营养在支气管肺发育不良的预防和管理中的作用。

The role of nutrition in the prevention and management of bronchopulmonary dysplasia.

作者信息

Biniwale Manoj A, Ehrenkranz Richard A

机构信息

Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.

出版信息

Semin Perinatol. 2006 Aug;30(4):200-8. doi: 10.1053/j.semperi.2006.05.007.

Abstract

Nutrition plays a critical role in the prevention and management of bronchopulmonary dysplasia (BPD). Growth failure in infants with BPD is predominantly due to malnutrition. Malnutrition can worsen BPD by compromising lung growth. Feeding difficulties in these infants can further affect nutrition. Dexamethasone, used to facilitate extubation and treat severe BPD, is known to have adverse effects on growth. Nutritional management of very low birth weight (VLBW) infants should be addressed from the first day of life to enhance growth and minimize respiratory morbidity. Fluid restriction, parenteral nutrition with protein and lipids, and early enteral feeding may help decrease the incidence of BPD. High calorie concentrated formula can be used in infants to achieve adequate growth if total daily fluid intake is restricted. Vitamin A supplementation may help to prevent further damage to lungs. The role of such therapies as inositol, vitamin E, and selenium in management of these infants remains speculative. Close post discharge follow up of infants with BPD is necessary to monitor growth and to ensure intake of sufficient protein and calories.

摘要

营养在支气管肺发育不良(BPD)的预防和管理中起着关键作用。患有BPD的婴儿生长发育迟缓主要是由于营养不良。营养不良会通过损害肺部生长而使BPD恶化。这些婴儿的喂养困难会进一步影响营养状况。用于促进拔管和治疗重度BPD的地塞米松已知对生长有不良影响。极低出生体重(VLBW)婴儿的营养管理应从出生第一天开始,以促进生长并尽量减少呼吸道疾病。液体限制、含蛋白质和脂质的肠外营养以及早期肠内喂养可能有助于降低BPD的发生率。如果每日总液体摄入量受限,可在婴儿中使用高热量浓缩配方奶粉以实现充足的生长。补充维生素A可能有助于预防肺部进一步受损。肌醇、维生素E和硒等疗法在这些婴儿管理中的作用仍存在推测性。对患有BPD的婴儿出院后进行密切随访对于监测生长情况以及确保摄入足够的蛋白质和热量是必要的。

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