Energy requirements in sick preterm babies

Wilson, DC; McClure, G

doi:10.1111/j.1651-2227.1994.tb13400.x

Cited by 18 publications

(13 citation statements)

References 29 publications

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“…5 Specific neonatal morbidity (ventilator and oxygen dependent infants) may also increase metabolic demands by as much as 25% compared to controls. 6,7 The Committee on Nutrition of the American Academy of Pediatrics have recommended a caloric intake of 120 kcal/kg/ day for children enterally fed and 80 to 100 kcal/kg/day for those parenterally fed, with a protein intake of 3.5 to 4 g/kg/day. 3 However, it is difficult for most VLBW infants to reach this suggested caloric and protein intake in the first two months of age.…”

Section: Introductionmentioning

confidence: 99%

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Dinerstein¹,

Nieto²,

Solana³

et al. 2006

J Perinatol

152

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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.

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Section: Introductionmentioning

confidence: 99%

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Dinerstein¹,

Nieto²,

Solana³

et al. 2006

J Perinatol

152

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show abstract

“…A baby weighing 1000 g at birth has only 2% of body weight as fat and <0.5% as glycogen compared with 15% and 1.2%, respectively, in the term infant 10. There may also be increased metabolic demands in ventilated VLBW infants, because studies in both ventilator dependent and oxygen dependent babies with BPD have shown that energy expenditure is about 25% higher than in controls 11. Undernutrition has many effects in the sick VLBW infant.…”

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confidence: 99%

Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants

Wilson¹,

Cairns²,

Halliday³

et al. 1997

Archives of Disease in Childhood - Fetal and Neonatal Edition

249

139

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Aims-To improve energy intake in sick very low birthweight (VLBW) infants; to decrease growth problems, lessen pulmonary morbidity, shorten hospital stay, and avoid possible feeding related morbidity. Morbidity in VLBW infants thought to be associated with parenteral and enteral feeding includes bronchopulmonary dysplasia, necrotising enterocolitis, septicaemia, cholestasis and osteopenia of prematurity. Methods-A prospective randomised controlled trial (RCT) comparing two types of nutritional intervention was performed involving 125 sick VLBW infants in the setting of a regional neonatal intensive care unit. Babies were randomly allocated to either an aggressive nutritional regimen (group A) or a control group (group B). Babies in group B received a conservative nutritional regimen while group A received a package of more aggressive parenteral and enteral nutrition. Statistical analysis was done using Student's t test, the Mann-Whitney U test, the 2 test and logistic regression. Results-There was an excess of sicker babies in group A, as measured by initial disease severity (P <0.01), but mean total energy intakes were significantly higher (P <0.001) in group A at days 3 to 42 while receiving total or partial parenteral nutrition. Survival and the incidences of bronchopulmonary dysplasia, septicaemia, cholestasis, osteopenia and necrotising enterocolitis were similar in both groups. Growth in early life and at discharge from hospital was significantly better in babies in group A. There were no decreases in pulmonary morbidity or hospital stay. Conclusion-Nutritional intake in sick VLBW infants can be improved without increasing the risk of adverse clinical or metabolic sequelae. Improved nutritional intake resulted in better growth, both in the early neonatal period and at hospital discharge, but did not decrease pulmonary morbidity or shorten hospital stay. (Arch Dis Child 1997;77:F4-F11)

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“…However, we should recognize that most studies concern 'healthy' or stable preterm infants and that little is known about the metabolic impact of particular diseases, and how all this affects the needs of the infant [98][99][100][101]. Although some research has been done regarding the metabolic differences and capabilities between small-for-gestational-age and appropriate-for-gestational-age infants, this has not led to a comprehensive nutritional strategy that suits their specific demands.…”

Section: Resultsmentioning

confidence: 91%

Nutritional support for extremely low-birth weight infants: abandoning catabolism in the neonatal intensive care unit

Akker

Vlaardingerbroek

Goudoever

2010

Current Opinion in Clinical Nutrition and Metabolic Care

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Energy requirements in sick preterm babies

Cited by 18 publications

References 29 publications

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants

Nutritional support for extremely low-birth weight infants: abandoning catabolism in the neonatal intensive care unit

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