Hussain Afaq, Rehman Abdur, Fatima Nazia
Dr. Afaq Hussain, FCPS (Paeds Med), Trainee, Children Hospital Complex and the Institute of Child Health, Multan, Pakistan.
Dr. Abdur Rehman, FCPS (Paeds Med) FCPS (Neonatal Paeds Med), Assistant Professor and Head of Neonatal ICU, Children Hospital Complex and the Institute of Child Health, Multan, Pakistan.
Pak J Med Sci. 2018 Jan-Feb;34(1):78-81. doi: 10.12669/pjms.341.14092.
To determine the outcomes in very low birth weight (VLBW) neonates receiving volume advancement versus frequency advancement feeding protocols.
This controlled clinical trial was conducted in Children Hospital Multan within duration of 6 months from February 2017 to August 2017. VLBW neonates having weight < 1500 g at the time of birth were included. The protocol for frequency advancement (FA) group was to give 1 ml/kg human or pre-formula milk after every 8 hours and in volume advancement (VA) group after every 3 hours initially. After three days, in FA group duration of feeds was decreased gradually from 8 to 2 hours and feed volume of 10 ml.kg.day until full-recommended dose of feeding i.e. 150 ml.kg.day reached. While in VA group, volume of 20 ml.kg.day was given until full-recommended dose of feeding reached. Days to achieve full feed, weight gain, and length of hospital stay were primary study outcomes.
Baseline weight of neonates was 1148 (111) grams in VA 1179 (106) grams in FA groups (p-value 0.18). In VA group, full feed was achieved in 11.04 (2.38) days versus 15.76 (2.48) days in FA group (P-value <0.001). Duration of IV fluid therapy were 13.5 (8.4) days in FA group versus 9.4 (7.6) in VA group (p-value <0.001). Moreover weight gain at the end of feeding protocol was significantly higher in VA group 1440 (78) grams versus 1284 (99) grams in FA group (P-value <0.001). Necrotizing entero-colitis occurred in only one neonate that was belonging to volume advancement group.
Volume advancement (VA) feeding is better as compared to frequency advancement (FA) feeding in very low birth weight neonates.
确定极低出生体重（VLBW）新生儿接受容量递增喂养方案与频率递增喂养方案的效果。
这项对照临床试验于2017年2月至2017年8月在木尔坦儿童医院进行，为期6个月。纳入出生时体重<1500g的极低出生体重新生儿。频率递增（FA）组的方案是每8小时给予1ml/kg人乳或配方奶，容量递增（VA）组最初每3小时给予一次。三天后，FA组的喂养时长从8小时逐渐减少至2小时，喂养量为10ml.kg·天，直至达到全推荐喂养量即150ml.kg·天。而VA组则给予20ml.kg·天的量，直至达到全推荐喂养量。实现全量喂养的天数、体重增加情况和住院时长为主要研究结果。
VA组新生儿的基线体重为1148（111）克，FA组为1179（106）克（p值0.18）。VA组在11.04（2.38）天实现全量喂养，而FA组为15.76（2.48）天（P值<0.001）。FA组静脉输液治疗时长为13.5（8.4）天，VA组为9.4（7.6）天（p值<0.001）。此外，喂养方案结束时VA组的体重增加明显更高，为1440（78）克，FA组为1284（99）克（P值<0.001）。坏死性小肠结肠炎仅发生在一名属于容量递增组的新生儿身上。
在极低出生体重新生儿中，容量递增（VA）喂养比频率递增（FA）喂养更好。
