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OBJECTIVE: To explore role of Lactobacillus reuteri DSM 17938 in the early feeding tolerance,growth and infection prevention of preterm infants. METHODS: The clinical data of 93 cases of preterm infants admitted between January 2017 and June 2018 to the First Department of Neonatology,Shengjing Hospital of China Medical University were analyzed retrospectively. All thecases weredividedintotheinterventiongroup(n=45)and the control group(n=48). Both groups of preterm infants were fed with the same type of premature infant formula and received parenteral nutrition if necessary. The intervention groupwas givena dose of 1×108 colony-forming units(5 drops)of Lactobacillus reuteri DSM 17938 once a day,until discharge.The control group did not take any probiotics. The early feeding tolerance,reflux,growth,nosocomial infection,neonatal necrotizing enterocolitis and adverse effects were observed in both groups of preterm infants. RESULTS: The incidence of vomiting,abdominal distension and gastric retention in the intervention group was lower than that in the control group(P0.05). The length of hospital stay was shorter in intervention group than in the control group(P<0.05). No adverse effects were found in the intervention group. CONCLUSION: Lactobacillus reuteri DSM 17938 can improve the early feeding tolerance of preterm infants,reduce reflux,promote growth and shorten the length ofhospitalstay.
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Feeding small for gestational age newborns is extremely challenging for the neonatologist. Awareness that these babies are at high risk for feeding intolerance and necrotising enterocolitis has led to a common practice of delaying the introduction of enteral feeds.Nevertheless,prolonging enteral fasting after birth is not justified on the basis of necrotising enterocolitis incidence or feeding tolerance.This review will focuse on the optimum timing for introduction of enteral feeding,increasing the amount of feeding,the importance of breastfeeding,feeding method,feeding intolerance and necrotising enterocolitis in small for gestational age infants.
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Objective To systematically review the efficacy and safety of erythromycin on enteral nutrition (EN) tolerance in adult critical care patients.Methods Databases including PubMed,EMbase,the Cochrane Library,CNKI and Wangfang data were retrieved up to June,2013 to collect the randomized controlled trial (RCT) concerning erythromycin in improving EN tolerance or increasing the successful rate of postpyloric EN tube as compared with other treatments.Two reviewers independently screened the literature,extracted the data,and assessed the quality of methodology.Then Meta-analysis was performed using RevMan 5.2 software.Results A total of 16 RCTs were included.Ten RCTs involving 668 patients were included for evaluating erythromycin in improving EN tolerance.Six RCTs involving 353 patients were included for evaluating erythromycin to increase the successful rate of postpyloric EN tube.The result of Meta-analysis showed that compared with placebo,erythromycin could significantly improve the successful rate of postpyloric EN tube placement [relative risk (RR) =1.82,95％ confidence interval (95％CI) 1.40-2.37,P＜0.000 01],while there was no significant difference between erythromycin and metoclopramide (RR=1.04,95％ CI 0.79-1.36,P=0.799).In patients who needed early EN,compared with placebo or blank control,erythromycin had higher successful gastric feeding rate over 5 days (RR =1.89,95％ CI 1.19-3.00,P=0.007).In patients who failed EN,compared with metoclopramide,erythromycin could significantly increase the successful gastric EN rate for 24 hours (RR=1.30,95％CI 1.02-1.66,P=0.03),72 hours (RR=1.57,95％CI 1.15-2.14,P=0.005) and 144 hours (RR=2.04,95％CI 1.23-3.37,P=0.006).The median time of EN intolerance was postponed in erythromycin group than that in metoclopramide group.Adverse reactions were reported in 5 studies.There was no statistic difference except for the higher diarrhea rate in the combination treatment group compared with erythromycin group.Conclnsions Postpyloric EN tube placement rate can be improved by erythromycin,which could be a choice of substitute for bedside intubation without fluoroscopy or endoscopic assistance.Based on the evidence,we recommended that intravenous erythromycin in a small dose of approximately 3 mg/kg weight as an option for EN intolerance in critical patients.
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Objective To explore the influence of different feeding methods on feeding tolerance and nutritional status of preterm infants.Methods Forty-eight cases of preterm infants were randomly divided into experiment group and control group,24 cases in each group.The experiment group adopt 24 hours continuous feeding by infusion pump,and the control group with syringe injection,with injection time of 3~5mins every 2 hours.The two groups were compared in terms of feeding tolerance,body weight and nutritional status.Results The feeding intolerance of experiment group was lower than that in the control group,weight and prealbumin were higher than those in the control group(P<0.05 or P<0.01).Conclusion The continuous feeding is the ideal feeding method,which can improve growth,feeding tolerance and nutritional status of preterm infants.
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PURPOSE: To compare the oral feeding tolerance that reflects a general maturity of organization of behavior and response among preterm twins less than 34 weeks of gestation conceived after in vitro fertilization with/without embryo transfer (IVF-ET) with that of natural conception. METHODS: Medical records of 135 preterm twins less than 34 weeks of gestation (74 twins conceived after IVF-ET and 61 spontaneously conceived twins) admitted to the Neonatal Intensive Care Unit (NICU) of Dong-A Medical Center during the period from January 2003 to December 2010 were used for a retrospective study. The primary study outcomes were perinatal mortality and overall short term morbidity. The secondary study outcome was oral feeding tolerance. RESULTS: There was no difference among the two groups in the gestational age and birth weight. Perinatal mortality rate and morbidity rate was not different between the two groups. In terms of feeding practice, there was no significant difference in terms of the starting date of first enteral feeding (4.1+/-4.5 days vs. 3.5+/-3.6 days, IVF-ET twin group vs. spontaneous twin group), the time it took to reach full enteral feeding (26.7+/-20.5 days vs. 27.6+/-24.3 days), the time it took to reach full oral feeding (34.4+/-21.7 days vs. 34.3+/-24.1 days) and PMA upon full oral feeding (36.0+/-2.2 weeks vs. 36.0+/-1.8 weeks), the duration of total parenteral nutrition (23.1+/-21.0 days vs. 24.9+/-24.3 days), displaying similar oral feeding tolerance. CONCLUSION: There was no difference in oral feeding tolerance between two groups.