Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
J Matern Fetal Neonatal Med. 2022 Jan;35(2):341-347. doi: 10.1080/14767058.2020.1716723. Epub 2020 Jan 29.
To determine the effect of two different feeding strategies on time to achieve full enteral feeding and the incidence of feeding intolerance in preterm infants with birth weight ≤1250 g.
A prospective randomized trial (NCT02913677) conducted at a tertiary level neonatal intensive care unit. Preterm infants with birth weight ≤1250 g were randomly allocated to either prolonged minimal enteral nutrition (MEN) in which feed volumes were not increased for five days or early feeding advancement groups in which feed volumes were advanced by 20-25 ml/kg/d until 150 ml/kg/d feed volume was achieved. The primary outcomes were time to reach full enteral feeding sustained for 72 h and incidence of feeding intolerance.
A total of 199 infants (99 in prolonged MEN and 100 in early feeding advancement groups) were involved in the study. No statistically significant differences were observed in time to achieve full enteral feeding and feeding intolerance. Daily weight gain (19 versus 16 g; < .001) was significantly higher in prolonged MEN group. There were no significant differences in weight percentiles and -scores at discharge. Duration of hospitalization was comparable between the groups. The overall incidence of late onset sepsis and culture proven sepsis was similar in both groups ( = .92 and = .22, respectively). Incidence of necrotizing enterocolitis (NEC) was 5% in early feeding advancement group, whereas no case of NEC was observed in prolonged MEN group ( = .06).
Prolonged MEN is not associated with a delay in time to achieve full enteral feedings. It may even provide an advantage for development of NEC in extremely low birth weight infants.
Clinical Trials.gov: NCT02913677.
比较两种不同喂养策略对≤1250g 极低出生体重儿达到全肠内喂养时间及喂养不耐受发生率的影响。
前瞻性随机对照试验（NCT02913677），在三级新生儿重症监护病房进行。将出生体重≤1250g 的早产儿随机分为延长微量喂养（MEN）组和早期喂养组。在 MEN 组，喂养量在 5 天内不增加；在早期喂养组，喂养量每天增加 20-25ml/kg，直到达到 150ml/kg。主要结局是达到全肠内喂养的时间（持续 72 小时）和喂养不耐受的发生率。
共有 199 例婴儿（延长 MEN 组 99 例，早期喂养组 100 例）参与了研究。两组达到全肠内喂养的时间和喂养不耐受的发生率无统计学差异。延长 MEN 组的日体重增加量（19 比 16g； < .001）明显更高。两组出院时的体重百分位数和 -评分无显著差异。两组的住院时间无差异。两组晚发型败血症和培养证实的败血症的总发生率相似（ = .92 和 = .22，分别）。早期喂养组坏死性小肠结肠炎（NEC）的发生率为 5%，而延长 MEN 组未观察到 NEC 病例（ = .06）。
延长 MEN 喂养不会延迟达到全肠内喂养的时间。它甚至可能对极低出生体重儿 NEC 的发生有优势。
ClinicalTrials.gov：NCT02913677。
