口腔运动干预对接受治疗性低温的缺氧缺血性脑病新生儿喂养结局的疗效。

The efficacy of oral motor interventions on feeding outcomes in newborns with hypoxic-ischemic encephalopathy who received therapeutic hypothermia.

机构信息

Neonatal Intensive Care Unit, Sanliurfa Training and Research Hospital, Şanlıurfa.

出版信息

Turk J Pediatr. 2023;65(6):949-958. doi: 10.24953/turkjped.2023.349.

DOI:10.24953/turkjped.2023.349

PMID:38204309

Abstract

BACKGROUND

Feeding difficulties continue to be a serious problem in newborns with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). The aim of this study was to investigate the efficacy of oral motor interventions (OMI) on feeding outcomes in neonates with HIE/TH.

METHODS

This was a prospective randomised control study conducted between January 2022 and September 2022. Premature Infant Oral Motor Intervention (PIOMI) was used as OMI. Newborns with HIE/TH, who underwent PIOMI, constituted the study group, and newborns, who did not receive any feeding exercise, constituted the control group. Transition time to full oral feeding (FOF) was determined as the time between initiation of tube feeding and full oral breastfeeding or bottle feeding. The day per oral (PO) feeding was started was specified as PO first, the day the infants could take half of the volume of the feedings by mouth was PO half, and the day the infants could take all the feedings by mouth was PO full.

RESULTS

There were 50 neonates in each group. Time to FOF was significantly shorter in the study group than in the control group in all stages of HIE/TH (P= 0.008 for stage 1, and < 0.001 for stage 2 and 3 HIE). However, times to PO first, PO half, PO full and discharge were shorter in the study group than in the control group only in the neonates with stage 3 HIE (P= 0.003, 0.014, 0.013, 0.042, respectively).

CONCLUSIONS

The PIOMI, which could be named as HIE-OMI in our study, is an effective intervention in shortening the transition time to FOF in neonates with all stages of HIE undergoing TH. In addition, HIEOMI shortens the length of hospital stay, and improves feeding outcomes in neonates with severe HIE/TH.

摘要

背景

在接受治疗性低温治疗（TH）的缺氧缺血性脑病（HIE）新生儿中，喂养困难仍然是一个严重的问题。本研究旨在探讨口腔运动干预（OMI）对 HIE/TH 新生儿喂养结局的疗效。

方法

这是一项前瞻性随机对照研究，于 2022 年 1 月至 9 月进行。采用早产儿口腔运动干预（PIOMI）作为 OMI。接受 PIOMI 的 HIE/TH 新生儿为研究组，未接受任何喂养运动的新生儿为对照组。完全口服喂养（FOF）的过渡时间定义为开始管饲到完全口服母乳喂养或奶瓶喂养的时间。开始经口（PO）喂养的天数为 PO 首次，婴儿可以经口摄入半量喂养的天数为 PO 半，婴儿可以经口摄入全部喂养的天数为 PO 全。

结果

每组各有 50 例新生儿。在 HIE/TH 的所有阶段，研究组的 FOF 时间均明显短于对照组（HIE 1 期为 P=0.008，2 期和 3 期为 <0.001）。然而，仅在 3 期 HIE 新生儿中，研究组的 PO 首次、PO 半、PO 全和出院时间均短于对照组（分别为 P=0.003、0.014、0.013、0.042）。