Effects of early minimal enteral nutrition on the immune system in newborn infants under mechanical ventilation with intratracheal intubation / 中国小儿急救医学

ABSTRACT

Objective To study the effect of minimal enteral nutrition on the immune system of newborn infants under mechanical ventilation (MV) with intratracheal intubation.Methods Eighty-one patients under MV with intratracheal intubation were divided into two groupstreatment group and control group.Forty patients in treatmet group accepted early minimal enteral nutrition,while other 41 patients in control group accepted normal feeding,then T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM),occurane of secondary infection,time of beginning fully enteral feeding,occurance of abdominal distension were recorded.Results There were no significant differences of T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM) changes between the two groups in which the time of patients beginning MV under intratracheal intubation was less than five days (P ＞ 0.05) ; while comparing patients in the two groups whose MV time was equal or greater than five days,the changes of T-lymphocytes CD3[(37.3 ± 1.6)％,(42.6 ±2.8)％],CD4[(29.1 ±1.7)％,(34.6 ±2.1)％],CD4/CD8 (17.9 ±1.8,18.9 ± 1.6),immunoglobulins IgA[(55.42 ±3.98) mg/L,(129.00 ±7.76) mg/L],IgM[(130.29 ±10.92) mg/L,(317.33 ± 11.64) mg/L] in treatment group were more significant than those in control group(P ＜0.05) ;furthermore the differences of the secondary infection occurance,the time beginning fully enteral feeding,intravenous nutrition and hospital stays in the treatment group [20％ (8/40),(8.56 ± 1.78) d,(10.56 ± 1.78) d,(12.63 ± 1.73) d] were lower significantly than those in the control group [48.78％ (20/41),(10.20 ± 1.65) d,(12.15 ± 1.69) d,(14.15 ± 1.64) d] (P ＜ 0.05).These were no significant differences on abdominal distension and gastric retention between the treatment group [20％ (8/40),17.5％ (7/40)]and the control group [24.39％ (10/41),19.51％ (8/41)] (P ＞ 0.05).Conclusion Early minimal enteral nutrition in infants under long time MV with intratracheal intubation could improve immune function recovery,reduce the occurance rate of secondary infection,shorten the time beginning fully enteral feeding,intravenous nutrition and hospital stay.