Department of Surgery, The Icahn School of Medicine Mount Sinai, New York, NY, USA.
The Icahn School of Medicine Mount Sinai. New York, NY, USA.
J Neonatal Perinatal Med. 2021;14(3):397-402. doi: 10.3233/NPM-200584.
Necrotizing enterocolitis (NEC) is a serious, often fatal, disease of neonates. Minimal data exists regarding the optimal method for reintroducing feeds after successful treatment. This study aims to compare outcomes in patients reintroduced to bolus or continuous feeds after treatment for medical NEC.
A retrospective review of infants treated for medical NEC in the neonatal intensive care unit (NICU) from 2011-2018 was performed. Demographics, information about initial feeds, clinical diagnosis data, and information about reintroduction of feeds were recorded. Patients with significant congenital heart disease or those who required procedures for treatment were excluded.
Sixty-one patients were analyzed; 45 were reintroduced to bolus feeds and 16 to continuous feeds. There were no differences between the two groups. Bolus-fed patients reached goal feeds quicker (p = 0.007), required fewer days of parenteral nutrition (p = 0.002), had shorter hospital stays (p = 0.013) and were discharged faster from diagnosis to discharge (p = 0.002). Differences were confirmed with multivariate regression.
Infants given bolus feeds reached goal feeds faster, required less time on PN, and were discharged quicker than those fed continuously. This suggests that, compared to continuous feeding, bolus feeding is associated with superior clinical outcomes among patients treated for medical NEC.
坏死性小肠结肠炎（NEC）是一种严重的、常致命的新生儿疾病。关于成功治疗后重新引入喂养的最佳方法的数据很少。本研究旨在比较在治疗医学 NEC 后重新引入推注或连续喂养的患者的结局。
对 2011-2018 年在新生儿重症监护病房（NICU）接受治疗的患有医学 NEC 的婴儿进行了回顾性研究。记录了人口统计学、初始喂养信息、临床诊断数据以及重新引入喂养的信息。排除患有重大先天性心脏病或需要手术治疗的患者。
分析了 61 例患者；45 例重新开始推注喂养，16 例开始连续喂养。两组之间没有差异。推注喂养的患者更快达到目标喂养量（p=0.007），需要的肠外营养天数更少（p=0.002），住院时间更短（p=0.013），从诊断到出院的出院时间更快（p=0.002）。多变量回归证实了这些差异。
与连续喂养相比，给予推注喂养的婴儿更快达到目标喂养量，需要的 PN 时间更少，出院更快。这表明，与连续喂养相比，在治疗医学 NEC 的患者中，推注喂养与更好的临床结局相关。
