Very low birth weight infants can tolerate higher rates of infusion of intravenous fat emulsion solutions during the first week of life without significant adverse events.
The objective of this study was to determine if there are any common “risk factors” that could assist clinicians in identifying premature infants who are at greater risk for developing necrotizing enterocolitis (NEC). This was a retrospective study of infants admitted to the neonatal intensive care unit at Children’s Hospital of Illinois, Peoria. In total, 384 charts were reviewed. Seventy-eight infants diagnosed with NEC were compared to 246 infants who did not have NEC. Maternal risk factors, infant demo-graphics, incidence of sepsis, H2 blockers prescribed, temperature, anemia, and day-of-life gut priming and enteral feedings were compared between the two groups for significant differences. Univariate tests and logistic regression demonstrated that mothers of infants who developed NEC had a higher incidence of premature rupture of membranes. Significantly more males developed NEC than females. African American infants had a higher incidence of developing NEC than white infants. Infants who developed NEC often had a prior diagnosis of sepsis and were prescribed H2 blockers more frequently. Infants who had early initiation of gut priming and earlier initiation of enteral feedings had significantly less incidence of NEC than infants whose gut priming and enteral feedings were delayed. This study supports that risk factors for NEC are multifactorial and could assist clinicians in identifying subgroups, within the neonatal population, that are at greater risk for this disease, leading to the implementation of strategies to reduce the onset of NEC. Unfortunately, the true etiology of NEC remains unclear.
The purpose of this study was to compare the clinical outcomes of 2 different oral feeding protocols. The old protocol advanced oral feedings based on established feeding times, whereas the new evidenced-based protocol advanced oral feedings using infant cues. This retrospective study, conducted by reviewing the charts of premature infants born less than or at 34 weeks' gestation, documented the differences between the 2 oral feeding protocols. The medical records were reviewed for 200 premature infants admitted to the neonatal intensive care unit at Children's Hospital of Illinois, Peoria, Illinois. The main outcome variables this study compared were when infants started oral feedings, time to achieve 50% and 100% feedings orally, weight at time of oral feeding, day of life, and postmenstrual age. The percentage of feedings when oral stimulation was ordered, frequency of feeding therapy consultations, length of stay, weight at the time of discharge, and postmenstrual age at the time of discharge were also compared. Infants participating in the new feeding protocol began oral feedings at an earlier postmenstrual age as compared to infants using the old feeding protocol. Participants enrolled in this new protocol did not experience adverse events. They were also able to progress to full oral feedings while maintaining adequate weight, had less need for feeding therapy consultations, and length of stay was not prolonged.
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