慢速输液间歇喂养对新生儿重症监护病房婴儿灌胃喂养相关心肺功能恶化的影响

Neonatal Medicine Pub Date : 2023-05-31 DOI:10.5385/nm.2023.30.2.49

Mi Jin Kim, H. S. Kim, Y. Jung, Changwon Choi

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引用次数: 0

摘要

目的：新生儿重症监护室（NICU）的婴儿在灌胃喂养过程中经常表现出心肺功能恶化。我们的目的是确定在新生儿重症监护室中，缓慢输注间歇喂养（SIIF）是否可以减少早产儿灌胃喂养期间的呼吸恶化。方法：回顾性分析因喂养相关心肺功能恶化而从推注重力喂养（2或3小时间隔）改为SIIF（用输液泵输注1小时，间隔3小时休息2小时）的早产儿的数据。显著的心肺事件被定义为饱和度低于80%或心率低于80 bpm。我们比较了应用SIIF前后24小时心肺事件的频率和呼吸支持水平。结果：共有34名婴儿被纳入研究并进行分析。应用SIIF后，去饱和或心动过缓的总频率显著降低（8.94 vs.5.03，P=0.001）。与喂养相关的心动过缓和去饱和的频率也显著降低（4.15 vs.1.68，P=0.008）。在34名患者中，11名（32.4%）患者在SIIF后1天内呼吸机支持水平下降。接受有创呼吸机支持的10名患者的呼吸严重程度评分在SIIF后显著下降（5.24对4.59，P=0.032）。结论：SIIF显著降低了约三分之一受试者的管饲相关心肺事件和呼吸支持。因此，SIIF可能是新生儿重症监护室早产儿灌胃喂养相关呼吸恶化的治疗选择。

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The Impact of Slow Infusion Intermittent Feeding on Gavage Feeding-Associated Cardiorespiratory Deterioration in Neonatal Intensive Care Unit Infants

Purpose: Infants in the neonatal intensive care unit (NICU) often show cardiorespiratory deterioration during gavage feeding. We aimed to determine whether slow infusion intermittent feeding (SIIF) can reduce respiratory deterioration during gavage feeding in preterm infants in the NICU.Methods: Data on preterm infants whose gavage feeding method was changed to SIIF (1-hour infusion with an infusion pump and 2-hour rest within a 3-hour interval) from bolus gravity feeding (2- or 3-hour interval) due to feeding-associated cardiorespiratory deterioration were retrospectively reviewed. A significant cardiorespiratory event was defined as a saturation level below 80% or heart rate below 80 bpm. We compared the frequency of cardiorespiratory events and the level of respiratory support 24 hours before and after the application of SIIF.Results: A total of 34 infants were enrolled and analyzed. The total frequency of desaturation or bradycardia significantly decreased after SIIF application (8.94 vs. 5.03, P=0.001). The frequency of feedingrelated bradycardia and desaturation also significantly decreased (4.15 vs. 1.68, P=0.008). Out of 34 patients, 11 (32.4%) had a decreased level of ventilator support within 1 day after SIIF. The respiratory severity scores of the 10 patients who received invasive ventilator support decreased significantly after SIIF (5.24 vs. 4.59, P=0.032).Conclusion: SIIF significantly decreased gavage feedingassociated cardiorespiratory events and reduced respiratory support in approximately onethird of subjects. Therefore, SIIF may be a therapeutic option for gavage feedassociated respiratory deterioration in preterm infants in the NICU.

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Neonatal Medicine

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审稿时长

12 weeks