University of Louisville School of Medicine, Division of Neonatal Medicine, Louisville, KY 40292, USA.
J Perinatol. 2012 Mar;32(3):227-9. doi: 10.1038/jp.2011.83. Epub 2011 Jun 23.
Once critically ill, preterm infants have transitioned to enteral or oral feedings, it is common to mix oral medications with milk feedings. The osmolality of oral and intravenous drugs were tested in the 1980s and many were found to exceed the American Academy of Pediatrics (AAP) recommended limit (400 mOsm kg(-1) H(2)O). Many new milks and medications have entered the neonatal intensive care unit (NICU) since then. The objective of this study was to measure the osmolality of common milk-medication combinations administered in the NICU.
Common milk-medication mixtures were analyzed for osmolality by freezing point depression.
Only Elecare (30 kcal per oz) exceeded AAP recommendations for osmolality in its unadulterated state. The addition of multivitamins alone resulted in an osmolality that exceeded 400 mOsm kg(-1) H(2)O. The cumulative addition of other medications resulted in some osmolalities >1000 mOsm kg(-1) H(2)O.
The coadministration of medications with milk products should be evaluated as a potential contributor to gastrointestinal intolerance of feedings in preterm infants.
一旦早产儿病情危急，需要过渡到肠内或口服喂养，通常将口服药物与奶液混合。20 世纪 80 年代，人们曾对口服和静脉用药物的渗透压进行测试，发现许多药物的渗透压超过美国儿科学会（AAP）推荐的限制（400mOsm/kg H2O）。此后，许多新的奶液和药物进入新生儿重症监护病房（NICU）。本研究的目的是测量 NICU 中常用的奶液-药物组合的渗透压。
通过冰点降低法分析常见的奶液-药物混合物的渗透压。
只有 Elecare（每盎司 30 卡路里）在未稀释状态下超过 AAP 对渗透压的建议。仅添加多种维生素就会导致渗透压超过 400mOsm/kg H2O。其他药物的累积添加导致一些渗透压>1000mOsm/kg H2O。
应评估药物与奶制品同时使用是否会导致早产儿喂养不耐受的胃肠道问题。
