Pereira-da-Silva L, Dias M Pitta-Grós, Virella D, Moreira A C, Serelha M
Neonatal Intensive Care Unit, Hospital Dona Estefânia, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Eur J Clin Nutr. 2008 Feb;62(2):274-8. doi: 10.1038/sj.ejcn.1602736. Epub 2007 Mar 21.
Addition of energy supplements to preterm formulas is an optional strategy to increase the energy intake in infants requiring fluid restriction, in conditions like bronchopulmonary dysplasia. This strategy may lead to an undesirable increase in osmolality of feeds, the maximum recommended safe limit being 400 mOsm/kg. The aim of the study was to measure the changes in osmolality of several commercialized preterm formulas after addition of glucose polymers and medium-chain triglycerides.
Osmolality was measured by the freezing point depression method. Six powdered formulas with concentrations of 14 g/100 ml and 16 g/100 ml, and five ready-to-feed liquid formulas were analyzed. All formulas, were supplemented with 10% (low supplementation) or 20% (high supplementation) of additional calories, respectively, in the form of glucose polymers and medium chain triglycerides, maintaining a 1:1 glucose:lipid calorie ratio. Inter-analysis and intra-analysis coefficients of variation of the measurements were always < 3.9%.
The mean osmolality (mOsm/kg) of the non-supplemented formulas varied between 268.5 and 315.3 mOsm/kg, increasing by 3-5% in low supplemented formulas, and by 6-10% in high supplemented formulas. None of the formulas analyzed exceeded 352.8 mOsm/kg.
The supplementation of preterm formulas with nonprotein energy supplements with up to 20% additional calories did not exceed the maximum recommended osmolality for neonatal feedings.
对于患有支气管肺发育不良等需要限制液体摄入的婴儿，在早产配方奶中添加能量补充剂是增加能量摄入的一种可选策略。这种策略可能会导致喂养液渗透压出现不良升高，最大推荐安全限度为400毫渗摩尔/千克。本研究的目的是测量添加葡萄糖聚合物和中链甘油三酯后几种商业化早产配方奶的渗透压变化。
采用冰点降低法测量渗透压。分析了六种浓度为14克/100毫升和16克/100毫升的粉状配方奶以及五种即食液体配方奶。所有配方奶分别以葡萄糖聚合物和中链甘油三酯的形式补充10%（低补充量）或20%（高补充量）的额外热量，保持葡萄糖:脂质热量比为1:1。测量的组间分析和组内分析变异系数始终<3.9%。
未补充配方奶的平均渗透压（毫渗摩尔/千克）在268.5至315.3毫渗摩尔/千克之间，低补充量配方奶增加3 - 5%，高补充量配方奶增加6 - 10%。所分析的配方奶均未超过352.8毫渗摩尔/千克。
用额外热量不超过20%的非蛋白质能量补充剂补充早产配方奶，未超过新生儿喂养推荐的最大渗透压。
