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接受整骨治疗的早产儿喂养时间的变化。

Timing of oral feeding changes in premature infants who underwent osteopathic manipulative treatment.

机构信息

NICU - Woman and Child Department, Del Ponte Hospital, Varese, Italy; Manima, Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy.

Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy; NICU - Department of Pediatrics, Ospedale dei Bambini "V.Buzzi", Milan, Italy.

出版信息

Complement Ther Med. 2019 Apr;43:49-52. doi: 10.1016/j.ctim.2019.01.003. Epub 2019 Jan 8.

Abstract

BACKGROUND

The delayed transition from gavage-to-nipple feeding is one of the most significant factors that may prolong hospital length of stay (LOS). Osteopathic manipulative treatment (OMT) has been demonstrated to be effective regarding LOS reduction, but no investigations have documented its clinical validity for attaining oral feeding.

OBJECTIVES

To assess OMT utility regarding the timing of oral feeding in healthy preterm infants.

DESIGN

Preliminary propensity score-matched retrospective cohort study.

SETTING

Data were extrapolated from the neonatal intensive care unit (NICU) of Del Ponte Hospital in Varese, Italy, during the period between March 2012 and December 2013.

INTERVENTIONS

Two propensity score-matched groups of healthy preterm infants aged 28 to 33 were compared, observing those supported with OMT until hospital discharge and control subjects.

MAIN OUTCOME MEASURES

Days from birth to the attainment of oral feeding was the primary endpoint. Body weight, body length, head circumference and LOS were considered as secondary endpoints.

RESULTS

Seventy premature infants were included in the study as the control group (n = 35; body weight (BW) = 1457.9 ± 316.2 g; gestational age (GA) = 31.5 ± 1.73 wk) and the osteopathic group (n = 35; BW = 1509.6 ± 250.8 g; GA = 31.8 ± 1.64 wk). The two groups had analogous characteristics at study entry. In this cohort, we observed a significant reduction in TOF (-5.00 days; p = 0.042) in the osteopathic group with a greater effect in very low birth weight infants.

CONCLUSIONS

These data demonstrate the utility and potential efficacy of OMT for the attainment of oral feeding. Further adequately powered clinical trials are recommended.

摘要

背景

从管饲到直接哺乳的延迟过渡是可能延长住院时间( LOS )的最重要因素之一。 整骨治疗( OMT )已被证明可有效减少 LOS ,但尚无研究记录其在实现口服喂养方面的临床有效性。

目的

评估 OMT 对健康早产儿开始口服喂养时间的作用。

设计

初步倾向评分匹配回顾性队列研究。

设置

数据从意大利瓦雷泽德尔庞特医院新生儿重症监护病房( NICU )提取,研究时间为 2012 年 3 月至 2013 年 12 月。

干预措施

将 28 至 33 周龄的两组健康早产儿进行倾向评分匹配,比较接受 OMT 支持直至出院的早产儿与对照组。

主要观察指标

从出生到达到口服喂养的天数是主要终点。体重、身长、头围和 LOS 为次要终点。

结果

研究纳入 70 例早产儿作为对照组(n=35;体重( BW )=1457.9±316.2 g;胎龄( GA )=31.5±1.73 周)和整骨组( n=35;BW=1509.6±250.8 g;GA=31.8±1.64 周)。两组在研究开始时具有相似的特征。在该队列中,我们观察到整骨组 TOF 显著减少(-5.00 天;p=0.042 ),极低出生体重儿的效果更为明显。

结论

这些数据表明 OMT 对实现口服喂养具有实用性和潜在疗效。建议进行进一步的、充分的临床疗效试验。

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