Bozzetti Valentina, Tagliabue Paolo E
Neonatal Intensive Care Unit, MBBM Foundation, San Gerardo Hospital, Monza.
Pediatr Med Chir. 2017 Jun 28;39(2):159. doi: 10.4081/pmc.2017.159.
Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN) because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g) or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants.
优化早产儿的营养管理对实现其长期健康至关重要。肠内营养优于全胃肠外营养（TPN），因为前者可避免与血管插管、败血症、TPN不良反应及禁食相关的并发症。由于早产儿缺乏协调吸吮、吞咽和呼吸的能力，对于大多数体重不足1500克的婴儿，管饲是必要的，以确保足够的喂养耐受性、支持最佳生长并降低误吸风险。因此，对于这些婴儿，采用经口胃管或鼻胃管喂养，持续或间歇推注配方奶或母乳是常见的做法。持续鼻饲母乳和间歇推注母乳的理论风险和益处都已被提出。根据文献，较小的婴儿（出生体重低于1250克者）或血流动力学受损的婴儿可能更适合持续营养；在生长稳定的婴儿中，营养可像健康足月儿一样间歇给予。
