Neiva Flávia C B, Leone Cléa R, Leone Claudio, Siqueira Lisiane L, Uema Kátia Akiko, Evangelista Daiana, Delgado Susana, Rocha Adriana, Buhler Karina Bernardis
College of Medicine, University Hospital Jundiai, Jundiai, SP, Brazil.
Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2014 Jun;69(6):393-7. doi: 10.6061/clinics/2014(06)05.
The assessment of early sucking by preterm infants provides information on the ability of these infants to efficiently and safely receive nutrients via an oral route (oral feeding). To analyze the application and reliability of an instrument in assessing non-nutritive sucking that indicates a capacity for oral feeding in the routine care of different neonatal units.
A multicenter, prospective cohort study was conducted in seven neonatal units. A non-nutritive sucking assessment with a formulary validated by Neiva et al (2008) (variables evaluated: rooting reaction; easy initiation of sucking; labial sealing; tongue central groove; peristaltic tongue movements; jaw raising and lowering movements; labial, tongue and jaw coordination; sucking strength; sucking rhythm; bites; excessive jaw excursion; stress signals) was applied to 199 pre-term newborns, who had a chronological age ≥ 2 days and were clinically stable. These infants were divided into two groups based on their corrected gestational age at the first assessment, as follows: Group I-infants with a gestational age ≤ 33 weeks and Group II-infants with a gestational age between 34 and 36 6/7 weeks.
The mean gestational age was 31.66±2 weeks, and the mean birth weight was 1494 ± 373 g. The mean scores on the non-nutritive sucking assessment were 46 ± 25 in Group I and 49 ± 24 in Group II. The beginning of oral feeding was successful in 43 (67.2%) infants in Group I and 64 (81%) infants in Group II (p = 0.089).
The method identified preterm infants who were able to feed orally based on 33 points in the non-nutritive sucking assessment and a corrected gestational age of 32 weeks or more. The corrected gestational age was the most important factor in predicting the success of oral feeding.
对早产儿早期吸吮功能的评估可为了解这些婴儿经口有效且安全摄取营养物质(经口喂养)的能力提供信息。分析一种用于评估非营养性吸吮的工具在不同新生儿病房常规护理中对经口喂养能力的应用及可靠性。
在七个新生儿病房开展了一项多中心前瞻性队列研究。对199例日龄≥2天且临床状况稳定的早产新生儿应用了由内瓦等人(2008年)验证的一份评估非营养性吸吮的表单(评估变量:觅食反射;吸吮启动难易程度;唇部闭合;舌中央沟;舌蠕动;下颌升降运动;唇、舌及下颌协调性;吸吮力度;吸吮节律;咬;下颌过度偏移;应激信号)。根据首次评估时的矫正胎龄将这些婴儿分为两组,如下:第一组——胎龄≤33周的婴儿;第二组——胎龄在34至36⁶/₇周之间的婴儿。
平均胎龄为31.66±2周,平均出生体重为1494±373克。第一组非营养性吸吮评估的平均得分是46±25分,第二组是49±24分。第一组43例(67.2%)婴儿经口喂养开始成功,第二组64例(81%)婴儿经口喂养开始成功(p = 0.089)。
该方法根据非营养性吸吮评估中的33分及32周或更大的矫正胎龄识别出能够经口喂养的早产儿。矫正胎龄是预测经口喂养成功的最重要因素。