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早期渐进性肠内喂养与极低出生体重儿生长的营养素摄入。

Nutrient Intake with Early Progressive Enteral Feeding and Growth of Very Low-Birth-Weight Newborns.

机构信息

Department of Neonatology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.

出版信息

Nutrients. 2022 Mar 11;14(6):1181. doi: 10.3390/nu14061181.

Abstract

Early nutrition is one of the most modifiable factors influencing postnatal growth. Optimal nutrient intakes for very preterm infants remain unknown, and poor postnatal growth is common in this population. The aim of this study was to assess nutrient intake during the first 4 weeks of life with early progressive enteral feeding and its impact on the in-hospital growth of very low-birth-weight (VLBW) infants. In total, 120 infants with birth weights below 1500 g and gestational ages below 35 weeks were included in the study. Nutrient intakes were assessed daily for the first 28 days. Growth was measured weekly until discharge. Median time of parenteral nutrition support was 6 days. Target enteral nutrient and energy intake were reached at day 10 of life, and remained stable until day 28, with slowly declining protein intake. Median z-scores at discharge were -0.73, -0.49, and -0.31 for weight, length, and head circumference, respectively. Extrauterine growth restriction was observed in 30.3% of the whole cohort. Protein, carbohydrates, and energy intakes correlated positively with weight gain and head circumference growth. Early progressive enteral feeding with human milk is well tolerated in VLBW infants. Target enteral nutrient intake may be reached early and improve in-hospital growth.

摘要

早期营养是影响产后生长的最可改变因素之一。极低出生体重儿(VLBW)最佳营养素摄入量仍不清楚,该人群的产后生长不良很常见。本研究旨在评估早期逐步肠内喂养期间的营养素摄入量及其对 VLBW 婴儿住院期间生长的影响。共有 120 名出生体重低于 1500 克且胎龄低于 35 周的婴儿纳入本研究。在最初的 28 天内每天评估营养素摄入量。生长每周测量一次,直到出院。静脉营养支持的中位时间为 6 天。目标肠内营养和能量摄入在生命的第 10 天达到,并稳定至第 28 天,蛋白质摄入缓慢下降。出院时体重、身长和头围的中位数 Z 评分分别为-0.73、-0.49 和-0.31。整个队列中有 30.3%的婴儿出现宫外生长受限。蛋白质、碳水化合物和能量摄入与体重增加和头围生长呈正相关。早期用母乳进行逐步肠内喂养可耐受良好。目标肠内营养摄入可能早期达到,并改善住院期间的生长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8df/8955398/8f28d90f4ff3/nutrients-14-01181-g001.jpg

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