Mednax National Medical Group, Tacoma, WA, USA.
Neonatal Intensive Care, Tacoma General Hospital, Tacoma, WA, USA.
Nutr Clin Pract. 2020 Apr;35(2):331-334. doi: 10.1002/ncp.10394. Epub 2019 Sep 4.
Necrotizing enterocolitis (NEC) is a major complication confronting clinicians caring for premature infants. This investigation compares clinical outcomes before and after quality improvement-program interventions in a population of premature infants at intermediate risk for NEC.
This study is a retrospective single-center chart review of infants admitted with a birth weight of 1000-1499 g, excluding major congenital anomalies, over a 6-year period, beginning with implementation of a donor breast-milk program when mother's own milk was not available. Infants were separated into 2 epochs, before (July 2012-December 2013) and after (April 2014-June 2018) introduction of human milk-derived fortifier (Prolacta) and a daily probiotic (FloraBABY) supplement.
Comparing 140 preintervention infants with 265 postintervention infants, NEC was significantly lower in the postintervention group: 5.2% vs 1.1% (P = 0.046). Somatic growth was similar in both epochs.
Quality-improvement initiatives utilizing an exclusive human-milk diet and daily probiotic supplementation were associated with a decreased incidence of NEC in infants with a birth weight of 1000-1499 g. Implementation of the NEC reduction bundle did not affect infant growth.
坏死性小肠结肠炎（NEC）是早产儿临床护理面临的主要并发症。本研究比较了在中危早产儿人群中，质量改进计划干预前后的临床结果。
本研究是对出生体重为 1000-1499 克、无重大先天畸形的婴儿进行的 6 年回顾性单中心图表回顾。从实施供体母乳计划开始，当母亲自己的母乳不可用时，排除在外。婴儿分为 2 个时期，干预前（2012 年 7 月至 2013 年 12 月）和干预后（2014 年 4 月至 2018 年 6 月），分别引入人乳衍生强化剂（Prolacta）和每日益生菌（FloraBABY）补充剂。
比较 140 例干预前婴儿和 265 例干预后婴儿，干预后组 NEC 发生率明显降低：5.2%比 1.1%（P=0.046）。两个时期的体生长相似。
利用纯人乳饮食和每日益生菌补充的质量改进措施与 1000-1499 克出生体重婴儿 NEC 发生率降低相关。NEC 减少方案的实施并未影响婴儿的生长。
