RESUMO
OBJECTIVE: To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time. METHODS: An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni- and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed. RESULTS: Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17-0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P < 0.001). CONCLUSIONS: Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age.
Assuntos
Ingestão de Energia , Transtornos do Crescimento/prevenção & controle , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Nutrição Parenteral , Análise de Variância , Nutrição Enteral , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Estudos Prospectivos , Estudos Retrospectivos , Aumento de PesoRESUMO
Se presenta un recién nacido con hipoglucemia refractaria al tratamiento, secundario e hiperinsulinismo. Se describen los hallazgos clínicos, de laboratorio, los diagnósticos diferenciales y el tratamiento con el propósito de analizar esta patología infrecuente.
Assuntos
Humanos , Recém-Nascido , Hiperinsulinismo , Hipoglicemia , Cromossomos Humanos Par 11 , Diagnóstico Diferencial , Diazóxido/administração & dosagem , Monitoramento de Medicamentos , Doenças do Recém-Nascido , Nifedipino , SomatostatinaRESUMO
Se presenta un recién nacido con hipoglucemia refractaria al tratamiento, secundario e hiperinsulinismo. Se describen los hallazgos clínicos, de laboratorio, los diagnósticos diferenciales y el tratamiento con el propósito de analizar esta patología infrecuente. (AU)
