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.
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.
Authors: P H Brener Dik; M F Galletti; S A Fernández Jonusas; G Alonso; G L Mariani; C A Fustiñana Journal: J Perinatol Date: 2015-06-11 Impact factor: 2.521
Authors: Richard A Ehrenkranz; Abhik Das; Lisa A Wrage; Brenda B Poindexter; Rosemary D Higgins; Barbara J Stoll; William Oh Journal: Pediatr Res Date: 2011-06 Impact factor: 3.756
Authors: Megan S Holden; Andrew Hopper; Laurel Slater; Yayesh Asmerom; Ijeoma Esiaba; Danilo S Boskovic; Danilyn M Angeles Journal: Infant Child Adolesc Nutr Date: 2014-08