口腔运动干预不同起始时间对改善早产儿喂养结局的效果：一项单盲、随机对照试验方案。

The effect of oral motor intervention with different initiation times to improve feeding outcomes in preterm infants: protocol for a single-blind, randomized controlled trial.

机构信息

Department of Neonatology Nursing, West China Second University Hospital, Sichuan University, Sichuan, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, No. 20, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, China.

出版信息

Trials. 2024 May 7;25(1):306. doi: 10.1186/s13063-024-08131-8.

DOI:10.1186/s13063-024-08131-8

PMID:38715042

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11075240/

Abstract

BACKGROUND

Premature infants commonly encounter difficulties with oral feeding, a complication that extends hospital stays, affects infants' quality of life, and imposes substantial burdens on families and society. Enhancing preterm infants' oral feeding skills and facilitating their transition from parenteral or nasal feeding to full oral feeding pose challenges for neonatal intensive care unit (NICU) healthcare professionals. Research indicates that oral motor interventions (OMIs) can enhance preterm infants' oral feeding capabilities and expedite the transition from feeding initiation to full oral feeding. Nonetheless, the most suitable timing for commencing these interventions remains uncertain.

METHODS

This is a single-blind, randomized controlled trial. Preterm with a gestational age between 29 to 34 weeks will be eligible for the study. These infants will be randomized and allocated to one of two groups, both of which will receive the OMIs. The intervention commences once the infant begins milk intake during the early OMIs. Additionally, in the late OMIs group, the intervention will initiate 48 h after discontinuing nasal continuous positive airway pressure.

DISCUSSION

OMIs encompass non-nutritive sucking and artificial oral stimulation techniques. These techniques target the lips, jaw, muscles, or tongue of premature infants, aiming to facilitate the shift from tube feeding to oral feeding. The primary objective is to determine the ideal intervention timing that fosters the development of oral feeding skills and ensures a seamless transition from parenteral or nasal feeding to full oral feeding among preterm infants. Furthermore, this study might yield insights into the long-term effects of OMIs on the growth and neurodevelopmental outcomes of preterm infants. Such insights could bear substantial significance for the quality of survival among preterm infants and the societal burden imposed by preterm birth.

TRIAL REGISTRATION

chictr.org.cn ChiCTR2300076721. Registered on October 17, 2023.

摘要

背景

早产儿普遍存在口腔喂养困难，这一并发症延长了住院时间，影响了婴儿的生活质量，并给家庭和社会带来了巨大负担。提高早产儿的口腔喂养技能，促进他们从肠内或鼻饲喂养过渡到完全口服喂养，这对新生儿重症监护病房（NICU）的医护人员来说是一个挑战。研究表明，口腔运动干预（OMI）可以增强早产儿的口腔喂养能力，并加速从喂养开始到完全口服喂养的过渡。然而，开始这些干预的最佳时机仍不确定。

方法

这是一项单盲、随机对照试验。胎龄为 29 至 34 周的早产儿有资格参加这项研究。这些婴儿将被随机分配到两个组中的一个，两个组都将接受 OMI。一旦婴儿在早期 OMI 期间开始摄入牛奶，干预就开始。此外，在晚期 OMI 组中，干预将在停止鼻持续气道正压通气 48 小时后开始。

讨论

OMI 包括非营养性吸吮和人工口腔刺激技术。这些技术针对早产儿的嘴唇、下巴、肌肉或舌头，旨在促进从管饲喂养到口服喂养的转变。主要目的是确定促进口腔喂养技能发展的理想干预时机，确保早产儿从肠内或鼻饲喂养顺利过渡到完全口服喂养。此外，这项研究可能会深入了解 OMI 对早产儿生长和神经发育结局的长期影响。这些见解对于提高早产儿的生存质量和减轻早产带来的社会负担具有重要意义。