[Clinical research of the enteral feeding of very low birth weight infants guided with a scoring system].

OBJECTIVE

Along with the elevation of survival rate of very low birth weight infants (VLBWI), the enteral feeding of VLBWI has become one of the most important factors, which influence the length of stay, short and long-term prognosis. This study aimed to explore safe and effective clinical protocols of VLBWI enteral feeding.

METHOD

According to different correlative degree of related factors to VLBWI enteral feeding, different scoring system was formulated for the enteral feeding and monitoring proposal of VLBWI. The safety and efficacy of the score system was evaluated.

RESULT

Forty-eight VLBWIs in group A was not treated with any score system, gestational age (30.0 ± 2.1) weeks, birth weight (1173 ± 170) g; while 48 VLBWIs in group B were guided with the scoring system, gestational age (30.3 ± 1.7) weeks, birth weight (1133 ± 238) g, there was no significant difference between two groups. The incidence of newborn respiratory distress syndrome of group B was significantly higher than that of group A (P = 0.016). The time of umbilical catheterization of group B was longer than that of group A. There was no significant difference in the incidence of other complications between two groups. The beginning milk volume, milk volume on the third, seventh, fourteenth, twenty-first, twenty-eight day of group B were significantly higher than that of group A [5.6 vs. 3.5 ml/(kg·d), P = 0.008, 12.3 vs. 5.7 ml/(kg·d), P = 0.000, 29.1 vs 8.9 ml/(kg·d), P = 0.000, 62.5 vs. 44.6 ml/(kg·d), P = 0.020, 98.1 vs. 71.5 ml/(kg·d), P = 0.005, 128.0 vs. 102.4 ml/(kg·d), P = 0.011]. The time achieving full enteral feeding of group B was shorter than that of group A (26.7 vs 32.9d, P = 0.007). The incidence of necrotizing enterocolitis in group B was lower than that of group A(0/48 vs. 4/48, P = 0.041). There was no significant difference of the total amino acid dosage between two groups. The total dosage of fatty emulsion was less, and the duration of parenteral nutrition was shorter in group B than in group A (50.3 vs. 73.9 g/kg, P = 0.000, 31.5 vs. 37.8 d, P = 0.016). There was no significant difference in length of stay between two groups. VLBWI of group B began to gain weight earlier [5.0 (4.3, 6.0) vs. 5.0 (5.0, 7.0) d, P = 0.028], regained birth weight earlier (9.2 vs. 11.6 d, P = 0.001), and got more weight in the second week (178 vs. 138 g, P = 0.020).

CONCLUSION

VLBWI guided with the scoring system achieved full enteral feeding faster, and shortened the duration of parenteral nutrition without increasing the incidence of necrotizing enterocolitis.