Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, 02115, USA.
Division of Newborn Medicine, Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
J Perinatol. 2018 Jul;38(7):936-943. doi: 10.1038/s41372-018-0110-2. Epub 2018 May 8.
Decrease time to enteral feeding initiation and advancement.
In our all-referral neonatal intensive care unit, we developed an evidence-based guideline addressing feeding initiation and advancement. During 6 months before and 7 months after guideline implementation, we measured time to initiate feeding, time to 100 ml/kg/day of feeding, gastric residual measurement frequency, and incidence of necrotizing enterocolitis (balancing measure).
Two hundred twenty-three infants were studied. Time from admission to feeding initiation was shorter after guideline implementation (mean 0.5 days [95% CI: 0.4-0.7] vs. 1.1 days [95% CI: 0.7-1.5], p = 0.01). Time from admission to 100 ml/kg/day feeding was also shorter (3.6 days [95% CI: 2.8-4.4] vs. 6.2 days [95% CI: 4.4-8.1], p = 0.01). After guideline implementation, routine gastric residual measurements were discontinued.
After implementation of an enteral feeding guideline, which included discontinuation of routine gastric residual assessment, we observed a faster initiation of enteral feeding and shorter time to reach 100 ml/kg/day.
缩短肠内喂养起始和推进的时间。
在我们的全转诊新生儿重症监护病房，我们制定了一项基于证据的指南，涉及喂养的起始和推进。在指南实施前 6 个月和实施后 7 个月，我们测量了开始喂养的时间、达到 100ml/kg/天喂养量的时间、胃残留测量频率以及坏死性小肠结肠炎的发生率（平衡措施）。
研究了 223 名婴儿。实施指南后，从入院到开始喂养的时间更短（平均 0.5 天[95%CI：0.4-0.7] vs. 1.1 天[95%CI：0.7-1.5]，p=0.01）。从入院到达到 100ml/kg/天喂养量的时间也更短（3.6 天[95%CI：2.8-4.4] vs. 6.2 天[95%CI：4.4-8.1]，p=0.01）。实施指南后，停止了常规胃残留测量。
在实施包括停止常规胃残留评估的肠内喂养指南后，我们观察到肠内喂养的起始更快，达到 100ml/kg/天的时间更短。
