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[经肠道喂养预防依赖动脉导管的先天性心脏病患儿胃肠道并发症的实践比较分析]

[Comparative analysis of enteral feeding practices for prevention of gastrointestinal complications in infants with ductus-dependent congenital heart diseases].

作者信息

Petrova N A, Kaplina A V, Kurzina E A, Nikiforov V G, Fedoseeva T A, Bairov V G

机构信息

Almazov National Medical Research Center of the Ministry of Healthcare of the Russian Federation, 197341, Saint Petersburg, Russian Federation.

出版信息

Vopr Pitan. 2020;89(5):44-58. doi: 10.24411/0042-8833-2020-10065. Epub 2020 Sep 20.

Abstract

Mesenterial hypoperfusion is one of the main pathogenetic factors of necrotizing enterocolitis (NEC) in infants with ductus-dependent congenital heart diseases. NEC in infants undergoing congenital heart surgery increases mortality and length of hospital stay. NEC is also associated with adverse neurodevelopmental outcome. Optimization of enteral feeding can reduce the risk of gastrointestinal complications. NEC risk factors in infants with congenital heart are of special interest in the literature. This article discusses criteria for enteral feeding initiation and increasing preoperatively and after heart surgery. Enteral feeding protocols of leading cardiac surgical centers are reviewed. Practices to provide high energy and nutrient consumption in infants with congenital heart disease are described.

摘要

肠系膜灌注不足是患有依赖动脉导管的先天性心脏病婴儿坏死性小肠结肠炎(NEC)的主要发病因素之一。接受先天性心脏手术的婴儿发生NEC会增加死亡率和住院时间。NEC还与不良的神经发育结局相关。优化肠内喂养可降低胃肠道并发症的风险。先天性心脏病婴儿的NEC危险因素在文献中备受关注。本文讨论了术前及心脏手术后开始肠内喂养及增加喂养量的标准。回顾了主要心脏外科中心的肠内喂养方案。描述了为先天性心脏病婴儿提供高能量和营养摄入的做法。

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