Early Aggressive Enteral Feeding in Neonates Weighing 750-1250 Grams: A Randomized Controlled Trial
Indian Pediatr
;
2019 Apr; 56(4): 294-298
Artigo
| IMSEAR
| ID: sea-199305
ABSTRACT
Background:
In preterm neonates, enteral feeding is advancedslowly, considering the risk of necrotizing enterocolitis. Prolongedintravenous alimentation in these neonates, however, mayincrease the risk of sepsis-related morbidity and mortality,particularly in low resource settings.Objectives:
Objective of this was study to evaluate impact ofaggressive enteral feeding on mortality and morbidities amongpreterm neonates.Design:
Randomized controlled trial.Participants:
Neonates with birthweight 750-1250 g.Interventions:
131preterm neonates with birth weight 750-1250g, admitted to neonatal intensive care unit between April 2012 andJune 2014, were randomized to aggressive feeding orconservative feeding regimen.Outcomes:
The primary outcome of the study was all-causemortality during hospital stay. The secondary outcomes includedproportion of sepsis (blood culture proven), necrotizingenterocolitis, feed intolerance, survival without major morbidity atdischarge, time to reach full enteral feed (180 mL/kg/d), durationof hospitalization, and average daily weight gain (g/kg).Results:
All-cause mortality was 33.3% in aggressive regimenand 43.1% in conservative regimen, [RR (95%) CI 0.77 (0.49,1.20)]. Neonates with aggressive feeding regimen reached fullenteral feed earlier; median (IQR) 7 (6, 8) days compared toconservative regimen, 10 (9, 14) days; P <0.001. There was nodifference in culture positive sepsis rate, survival without majormorbidities, feed intolerance, necrotizing enterocolitis, duration ofhospitalization and average daily weight gain.Conclusions:
In neonates with birth weight 750-1250 g, earlyaggressive feeding regimen is feasible but not associated withsignificant reduction in all-cause mortality, culture positive sepsisor survival without major morbidities during hospital stay.Neonates with aggressive regimen have fewer days on IV fluidsand reach full feed earlier
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Tipo de estudo:
Ensaio Clínico Controlado
Revista:
Indian Pediatr
Ano de publicação:
2019
Tipo de documento:
Artigo
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