早产儿营养实践指南的依从性：台湾的全国性调查。
Adherence to Nutritional Practice Guideline in Premature Infants: A Nationwide Survey in Taiwan.
机构信息
Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan.
Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung 404, Taiwan.
出版信息
Nutrients. 2024 Sep 20;16(18):3181. doi: 10.3390/nu16183181.
OBJECTIVES
This study aimed to assess the current neonatal nutritional practices in Taiwan and promote consensus on standardized protocols.
METHODS
An online questionnaire comprising 95 items on parenteral nutrition (PN) and enteral nutrition (EN) practices was distributed to neonatal care units across Taiwan via email between August and December 2022. The responses were compared with the recommendations from the European Society for Pediatric Gastroenterology Hepatology and Nutrition for preterm infant care.
RESULTS
Most of the 35 neonatal units, comprising 17 level III and 18 level II units, that participated in this study adhered to standard PN protocols; however, only 30% of units used protein-containing solutions as the initial fluid. Over half of the neonatal units provided calcium, phosphate, and magnesium at less than the recommended dosage. Trophic feeding commenced within 48 h in 88% of the units, with the mother's milk used as the first choice. All the units preferred commencing advanced feeding at <25 mL/kg/day.
CONCLUSIONS
Most nutrient protocols for preterm infants in neonatal units in Taiwan meet recent guidelines, but discrepancies such as lower mineral supplements in PN and a slower advancement of enteral feeding increase nutritional risk. These issues warrant further research.
目的
本研究旨在评估台湾地区新生儿的营养实践现状，并促进标准化方案的共识。
方法
本研究通过电子邮件向台湾地区的新生儿护理单位分发了一份包含 95 个项目的肠外营养（PN）和肠内营养（EN）实践的在线问卷，时间为 2022 年 8 月至 12 月。将这些回答与欧洲儿科胃肠病学、肝病学和营养学会（ESPGHAN）推荐的早产儿护理建议进行比较。
结果
参与本研究的 35 个新生儿单位中，包括 17 个 3 级单位和 18 个 2 级单位，大多数单位都遵守标准的 PN 方案；然而，只有 30%的单位使用含蛋白质的溶液作为初始液体。超过一半的新生儿单位给予的钙、磷和镁剂量低于推荐剂量。88%的单位在 48 小时内开始管饲喂养，首选母乳。所有单位都更喜欢在<25 毫升/公斤/天时开始高级喂养。
结论
台湾地区新生儿单位中早产儿的大多数营养方案都符合最新指南，但 PN 中矿物质补充不足和肠内喂养进展较慢等差异增加了营养风险。这些问题值得进一步研究。
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