M. Sousa, Ana Suely Vieira, Suely Ribeiro, L. Moreira
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引用次数: 1
Abstract
Objective : To assess the effects of parenteral nutrition (PN) initiation time in very low birth weight neonates on: the birth weight recovery time, enteral nutrition (EN) initiation time, duration of hospitalization, and incidence of death. Methods: This retrospective case-control study was performed in the neonatal intensive care unit (NICU) of a tertiary center: Santo Amaro Hospital, Salvador, Brazil. All infants with birth weights ≤ 1500 g who were treated in the NICU during the study period ( n= 114) were included. The sample was divided in two groups: early (≤ 48 h after birth) and late (> 48 h after birth) onset of PN. We also analyzed a subgroup of neonates with birth weights ≤ 750g, as well as a group for whom PN was initiated very early (≤ 24 h after birth). Results: A total of 114 neonates ( n= 48 / 39.8% in early PN group),were included in the study. Birth weight recovery time (9.9 ± 4.0 vs 12.8 ± 6.1, p = 0.007), lenght of hospitalization (43.2 ± 4.0 vs 71.8 ± 41.7, p = 0.007), and time of EN onset (2.2 ± 1.2 vs 7.9 ± 5.8, p <0.001) , were significantly lower in the early PN onset group than in the late onset group. Lenght of hospitalization was positively correlated with the timing of EN onset (r= 0,37, p = 0,001). No significant difference in adverse outcomes: death (18.6% vs 13.6%, p = 0.6), intracranial hemorrhage (ICH) (8.3% vs 12.1%, p = 0.9 ) and patent ductus arteriosus (PDA) (8.3% vs 31.8%, p = 0.1) was obbserved between groups. Conclusion: In this study, the early initiation of nutritional support in very low birth weight neonates can reduce the length of hospitalization thereby reducing costs, without increasing the incidence of adverse effects.
目的:探讨极低出生体重儿肠外营养(PN)起始时间对新生儿出生体重恢复时间、肠内营养起始时间、住院时间和死亡发生率的影响。方法:本回顾性病例对照研究在巴西萨尔瓦多圣阿马罗医院三级中心的新生儿重症监护病房(NICU)进行。研究期间在NICU治疗的所有出生体重≤1500 g的婴儿(n= 114)被纳入。将样本分为早期(出生后≤48 h)和晚期(出生后> 48 h)两组。我们还分析了一组出生体重≤750g的新生儿,以及一组很早就开始PN(出生后≤24小时)的新生儿。结果:114例新生儿(n= 48 /早期PN组39.8%)纳入研究。早发组新生儿出生体重恢复时间(9.9±4.0 vs 12.8±6.1,p = 0.007)、住院时间(43.2±4.0 vs 71.8±41.7,p = 0.007)、EN发病时间(2.2±1.2 vs 7.9±5.8,p <0.001)均显著低于晚发组。住院时间长短与EN发病时间呈正相关(r= 0,37, p = 0.001)。不良结局:组间死亡(18.6% vs 13.6%, p = 0.6)、颅内出血(8.3% vs 12.1%, p = 0.9)和动脉导管未闭(PDA) (8.3% vs 31.8%, p = 0.1)无显著差异。结论:在本研究中,极低出生体重新生儿早期开始营养支持可以缩短住院时间,从而降低费用,而不会增加不良反应的发生率。