OBJECTIVE: To evaluate the effect of slow vs rapid rates of advancement of enteral feed volumes on the clinical outcomes in preterm infants with 750-1250 g birth weight. STUDY DESIGN: A total of 92 stable neonates 750-1250 g and gestational age <32 weeks were randomly allocated to enteral feeding advancement of 20 mL/kg/d (n = 46) or 30 mL/kg/d (n = 46). The primary outcome was days to reach full enteral feeding, defined as 180 mL/kg/d. Secondary outcomes included rates of necrotizing enterocolitis (NEC) and culture-proven sepsis, days of parenteral nutrition (PN), length of hospital stay, and growth end points. RESULTS: Neonates in the rapid-feeding advancement group achieved full enteral volume of feedings earlier than the slower advancement group. They received significantly fewer days of PN, exhibited a shorter time to regain birth weight, and had a shorter duration of hospital stay. The incidence of NEC and the number of episodes of feeding intolerance were not significantly different between the groups, whereas the incidence of culture-proven late-onset sepsis was significantly less in infants receiving a rapid feeding advancement. Excluding infants who were small for gestational age at birth, the incidence of extrauterine growth restriction was significantly reduced in the rapid-advancement group at 28 days and at hospital discharge. CONCLUSION: Rapid enteral feeding advancements in 750-1250 g birth weight infants reduce the time to reach full enteral feeding and the use of PN administration. Rapid-advancement enteral feed also decreases extrauterine growth restriction with improved short-term outcomes for these high-risk infants.
RCT Entities:
OBJECTIVE: To evaluate the effect of slow vs rapid rates of advancement of enteral feed volumes on the clinical outcomes in preterm infants with 750-1250 g birth weight. STUDY DESIGN: A total of 92 stable neonates 750-1250 g and gestational age <32 weeks were randomly allocated to enteral feeding advancement of 20 mL/kg/d (n = 46) or 30 mL/kg/d (n = 46). The primary outcome was days to reach full enteral feeding, defined as 180 mL/kg/d. Secondary outcomes included rates of necrotizing enterocolitis (NEC) and culture-proven sepsis, days of parenteral nutrition (PN), length of hospital stay, and growth end points. RESULTS: Neonates in the rapid-feeding advancement group achieved full enteral volume of feedings earlier than the slower advancement group. They received significantly fewer days of PN, exhibited a shorter time to regain birth weight, and had a shorter duration of hospital stay. The incidence of NEC and the number of episodes of feeding intolerance were not significantly different between the groups, whereas the incidence of culture-proven late-onset sepsis was significantly less in infants receiving a rapid feeding advancement. Excluding infants who were small for gestational age at birth, the incidence of extrauterine growth restriction was significantly reduced in the rapid-advancement group at 28 days and at hospital discharge. CONCLUSION: Rapid enteral feeding advancements in 750-1250 g birth weight infants reduce the time to reach full enteral feeding and the use of PN administration. Rapid-advancement enteral feed also decreases extrauterine growth restriction with improved short-term outcomes for these high-risk infants.
Authors: Steven W Graves; Michael S Esplin; Paula McGee; Dwight J Rouse; Kenneth J Leveno; Brian M Mercer; Jay D Iams; Ronald J Wapner; Yoram Sorokin; John M Thorp; Susan M Ramin; Fergal D Malone; Mary J O'Sullivan; Alan M Peaceman; Gary D V Hankins; Donald J Dudley; Steven N Caritis Journal: Am J Obstet Gynecol Date: 2013-11-08 Impact factor: 8.661
Authors: Jon Dorling; Oliver Hewer; Madeleine Hurd; Vasha Bari; Beth Bosiak; Ursula Bowler; Andrew King; Louise Linsell; David Murray; Omar Omar; Christopher Partlett; Catherine Rounding; John Townend; Jane Abbott; Janet Berrington; Elaine Boyle; Nicholas Embleton; Samantha Johnson; Alison Leaf; Kenny McCormick; William McGuire; Mehali Patel; Tracy Roberts; Ben Stenson; Warda Tahir; Mark Monahan; Judy Richards; Judith Rankin; Edmund Juszczak Journal: Health Technol Assess Date: 2020-04 Impact factor: 4.014
Authors: Michael H Livingston; Jorge Zequeira; Henrietta Blinder; Julia Pemberton; Connie Williams; J Mark Walton Journal: Pilot Feasibility Stud Date: 2015-08-25