Thyagarajan Balamurugan, Tillqvist Emma, Baral Vijay, Hallberg Boubou, Vollmer Brigitte, Blennow Mats
Neonatal Unit, Princess Anne Hospital, Southampton, UK.
Acta Paediatr. 2015 Feb;104(2):146-51. doi: 10.1111/apa.12838. Epub 2014 Dec 29.
The safety and efficacy of enteral feeding during hypothermia treatment following hypoxic-ischaemic encephalopathy has not been studied before, resulting in variations in practice. Our study compared the benefits and safety of both early minimal and delayed enteral feeding during hypothermia treatment.
Our retrospective cohort study, from January 2009 to December 2011, compared a Swedish cohort, who received early enteral feeding during hypothermia, and a UK cohort, who received delayed enteral feeding.
In Sweden (n = 51), enteral feeds were initiated at a median of 23.6 h and full oral feeding was achieved at 9 days (range 3-23). In the UK (n = 34), the equivalent figures were 100 h and 8 days (range 3-13) (p = 0.01). Both groups achieved enteral feeding at a median 6 days. The median length of hospital stay was 13 days in Sweden and 10 days in the UK (p = 0.04). More babies were fully breastfeeding or breastfed and bottle-fed at discharge in Sweden (85%) than the UK (67%) (p = 0.08). There were no significant differences between the two groups regarding adverse events.
Early minimal enteral feeding during hypothermia proved feasible, with no significant complications. Delayed enteral feeding did not affect time to full enteral feeding.
缺氧缺血性脑病低温治疗期间肠内营养的安全性和有效性此前尚未得到研究，导致实践存在差异。我们的研究比较了低温治疗期间早期微量肠内营养和延迟肠内营养的益处与安全性。
我们的回顾性队列研究涵盖2009年1月至2011年12月，比较了瑞典队列（在低温治疗期间接受早期肠内营养）和英国队列（接受延迟肠内营养）。
在瑞典队列（n = 51）中，肠内营养开始的中位时间为23.6小时，9天时实现完全经口喂养（范围3 - 23天）。在英国队列（n = 34）中，相应数字为100小时和8天（范围3 - 13天）（p = 0.01）。两组实现肠内营养的中位时间均为6天。瑞典队列的中位住院时间为13天，英国队列为10天（p = 0.04）。瑞典出院时完全母乳喂养或母乳喂养加奶瓶喂养的婴儿比例（85%）高于英国（67%）（p = 0.08）。两组在不良事件方面无显著差异。
低温治疗期间早期微量肠内营养可行，无显著并发症。延迟肠内营养不影响完全肠内营养的时间。
