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早产儿补充益生菌:喂养不耐受与住院费用。

Probiotic Supplementation in Preterm: Feeding Intolerance and Hospital Cost.

机构信息

Department of Pediatric, Aldo Moro University of Bari, Ospedale Pediatrico Giovanni XXIII via Amendola 276, 70125 Bari, Italy.

Laboratory of Nutritional Physiopathology, National Institute for Digestive Diseases, Istituto di Ricerca e Cura a Carattere Scientifico (I.R.C.C.S.), Saverio de Bellis, 70013 Castellana Grotte (BA), Italy.

出版信息

Nutrients. 2017 Aug 31;9(9):965. doi: 10.3390/nu9090965.

Abstract

We hypothesized that giving the probiotic strain () DSM 17938 to preterm, formula-fed infants would prevent an early traumatic intestinal inflammatory insult modulating intestinal cytokine profile and reducing the onset of feeding intolerance. Newborn were randomly allocated during the first 48 h of life to receive either daily probiotic (10⁸ colony forming units (CFUs) of DSM 17938) or placebo for one month. All the newborns underwent to gastric ultrasound for the measurement of gastric emptying time. Fecal samples were collected for the evaluation of fecal cytokines. Clinical data on feeding intolerance and weight gain were collected. The costs of hospital stays were calculated. The results showed that the newborns receiving DSM 17938 had a significant decrease in the number of days needed to reach full enteral feeding ( < 0.01), days of hospital stay ( < 0.01), and days of antibiotic treatment ( < 0.01). Statistically significant differences were observed in pattern of fecal cytokine profiles. The anti-inflammatory cytokine interleukin (IL)-10, was increased in newborns receiving DSM 17938 Pro-inflammatory cytokines: IL-17, IL-8, and tumor necrosis factor (TNF)-alpha levels were increased in newborns given placebo. Differences in the gastric emptying and fasting antral area (FAA) were also observed. Our study demonstrates an effective role for DSM 17938 supplementation in preventing feeding intolerance and improving gut motor and immune function development in bottle-fed stable preterm newborns. Another benefit from the use of probiotics is the reducing cost for the Health Care service.

摘要

我们假设,给早产儿配方奶喂养的婴儿服用益生菌菌株(DSM 17938),可以预防早期创伤性肠道炎症损伤,调节肠道细胞因子谱,并减少喂养不耐受的发生。新生儿在生命的头 48 小时内随机分配接受每日益生菌(10⁸ 个 DSM 17938 菌落形成单位)或安慰剂治疗一个月。所有新生儿均接受胃超声检查以测量胃排空时间。收集粪便样本以评估粪便细胞因子。收集喂养不耐受和体重增加的临床数据。计算住院费用。结果表明,接受 DSM 17938 治疗的新生儿达到完全肠内喂养所需的天数明显减少(<0.01),住院天数(<0.01)和抗生素治疗天数(<0.01)。粪便细胞因子谱模式观察到统计学显著差异。抗炎细胞因子白细胞介素(IL)-10 在接受 DSM 17938 治疗的新生儿中增加,而促炎细胞因子 IL-17、IL-8 和肿瘤坏死因子(TNF)-alpha 水平在接受安慰剂的新生儿中增加。还观察到胃排空和空腹前胃区(FAA)的差异。我们的研究表明,DSM 17938 补充在预防喂养不耐受和改善奶瓶喂养稳定早产儿肠道运动和免疫功能发育方面具有有效作用。益生菌使用的另一个好处是降低医疗保健服务的成本。

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