Randomized trial of “slow” versus “fast” feed advancements on the incidence of necrotizing enterocolitis in very low birth weight infants  

Oleh:

Rayyis, Suha F. ; Ambalavanan, Namasivayam ; Wright, Linda ; Carlo, Waldemar A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 134 no. 3 (Mar. 1999), page 293-297 .
Topik: NEC ; Necrotizing enterocolitis; PDA ; Patent ductus arteriosus; VLBW ; Very low birth weight

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective: To determine whether the rate of feed advancement affects the incidence of necrotizing enterocolitis (NEC). Study design: Prospective randomized controlled trial involving 185 formula-fed infants with birth weight 501 to 1500 g and gestational age =34 weeks. Infants were randomized into 2 groups: “slow” (n = 98), who received 15 cc/kg/d increments (a 10-day schedule to full feeds) and “fast” (n = 87), who received 35 cc/kg/d increments (a 5-day schedule to full feeds) of Similac Special Care 20 cal/oz. Feeds were increased only if well tolerated as defined by a protocol. Results: The incidence of NEC (Bell stage =II) was similar in both groups (slow 13% and fast 9%, P = .5). The incidence of perforation (Bell stage III) was also similar in both groups (slow 4% and fast 2%, P = .8). Feeds were started at a comparable postnatal age in both groups (median age: slow 5 days and fast 4 days, P = .9). Although the neonates in the fast group attained full enteral intake earlier (median days [25th and 75th percentiles]: slow 15 [12, 21] and fast 11 [8, 15], P < .001) and regained their birth weight earlier (slow 15 [11, 20] and fast 12 [8, 15], P < .05), their ages at discharge were not statistically different (slow 47 [31, 67] and fast 43 [29, 62], P = .3) Conclusions: A greater than twofold difference in the rate of feed advancement from 15 cc/kg/d to 35 cc/kg/d did not affect the incidence of NEC = stage II. Factors other than feed advancement appear to be more important in the pathogenesis or progression of NEC.

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