Department of Paediatrics, Children's University Hospital, Jagiellonian University Medical College, Cracow, Poland.
J Mother Child. 2024 Mar 5;28(1):8-13. doi: 10.34763/jmotherandchild.20242801.d-23-00115. eCollection 2024 Feb 1.
The nutritional practice for newborns with hypoxic-ischaemic encephalopathy during therapeutic hypothermia differs among Polish neonatal care units, as no guidelines are provided. We assessed the prevailing procedures.
Data was collected through an anonymous, web-based questionnaire. We surveyed aspects of the current nutritional practices and the reasoning behind the choice of the feeding strategy.
Thirty-one responses were obtained (31/33, 94%). Based on participants' estimations, 342 newborns are diagnosed with hypoxic-ischaemic encephalopathy and qualified for therapeutic hypothermia annually. Among them, almost ⅓ is fed exclusively parenterally, while 71% both ways-parenterally and enterally. In the vast majority of units, the introduction of enteral nutrition takes place during the first 48 hours of therapeutic hypothermia, and breast milk is primarily provided, although with substantial first feeding volume differentiation (an average of 2,9 ml/kg (0,3 - 10ml/kg)). Adverse events, such as necrotising enterocolitis, sepsis, and glycemia level disturbances that derive from the initiation of enteral nutrition, are difficult to estimate as no official statistics are provided.
The majority of newborns after hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia are fed both parenterally and enterally during the procedure, predominantly with expressed or donor breast milk. However, due to the lack of nutritional guidelines, significant variability of nutritional strategies concerning initiation time, type and volume of enteral feeds given is noted. Therefore, further studies are required to clarify feeding recommendations.
在治疗性低温期间，患有缺氧缺血性脑病的新生儿的营养实践因波兰新生儿护理单位而异，因为没有提供指南。我们评估了流行的程序。
通过匿名的基于网络的问卷收集数据。我们调查了当前营养实践的各个方面以及选择喂养策略的理由。
获得了 31 份回复（31/33，94%）。根据参与者的估计，每年有 342 名新生儿被诊断患有缺氧缺血性脑病并符合治疗性低温条件。其中，近三分之一的新生儿接受完全肠外营养，而 71%的新生儿接受肠内和肠外营养。在绝大多数单位中，在治疗性低温的前 48 小时内开始进行肠内营养，主要提供母乳，尽管首次喂养量存在很大差异（平均 2.9ml/kg（0.3-10ml/kg））。由于没有提供官方统计数据，因此难以估计与开始肠内营养相关的坏死性小肠结肠炎、败血症和血糖水平紊乱等不良事件。
接受治疗性低温治疗的缺氧缺血性脑病后，大多数新生儿在治疗过程中同时接受肠内和肠外营养，主要使用表达或供体母乳。然而，由于缺乏营养指南，在开始时间、给予的肠内喂养的类型和量方面存在显著的营养策略变异性。因此，需要进一步研究以阐明喂养建议。
