早产儿肠内营养（2022）：ESP-GHAN 营养委员会及特邀专家的立场文件。
Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts.
机构信息
From the Newcastle Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, UK.
the Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
出版信息
J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):248-268. doi: 10.1097/MPG.0000000000003642. Epub 2022 Oct 28.
OBJECTIVES
To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g.
METHODS
The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-to-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached.
RESULTS
In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier.
CONCLUSIONS
We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants.
目的
回顾现有文献，就出生体重<1800 克的早产儿的营养素摄入量和营养实践达成共识结论和推荐意见。
方法
欧洲儿科学会胃肠病学、肝病学和营养学分会（ESPGHAN）营养委员会（CoN）牵头开展了一项工作流程，其中包括 CoN 成员和特邀专家。特邀专家根据其特定专长进行选择，以尽可能广泛地代表地域分布。制定了一份主题清单，并为每个主题指定了牵头人及其他成员，由他们审查现有文献。2020 年 2 月举行了一次面对面会议。2020 年至 2021 年期间制定了暂定结论和建议，并由工作组的所有成员在 2021 年至 2022 年期间进行电子投票。对于未达成>90%共识的情况，则举行在线讨论会议，并进行进一步投票，直至达成一致。
结果
总体而言，大多数营养素和主题都缺乏有力证据。本文的总结报告还附有额外的数字补充内容，对文献和相关生理学提供了更全面的解释：引言和概述；人乳参考数据；水、蛋白质、能量、脂质、碳水化合物、电解质、矿物质、微量元素、水溶性维生素和脂溶性维生素的摄入量；喂养方式包括矿物质肠内喂养、喂养进度、胃残留量管理、胃管放置和推注或连续喂养；生长；母乳口腔初乳、捐赠人乳以及巨细胞病毒感染的风险；水解蛋白和渗透压；补充生物营养素；以及使用母乳强化剂。
结论
我们提供了基于 ESPGHAN CoN 共识的最新营养素摄入量和营养管理早产儿的结论和推荐意见。
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