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

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

doi:10.1016/s0022-3476(99)70452-x

Cited by 164 publications

(110 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Entre los factores reconocidos como coadyuvantes en la presentación de la enfermedad, se encuentra la alimentación entérica (7). Sin embargo, se ha visto que la alimentación entérica mínima tiene ventajas en cuanto a que mejora la motilidad y la producción enzimática, y Pérez LA, Pradilla GL, Díaz G, Bayter SM alcanza los aportes óptimos de manera más rápida, sin aumentar el riesgo de enterocolitis necrosante (14)(15)(16)(17)20).…”

Section: Discussionunclassified

“…En varios estudios se informa sobre esto (20,(23)(24)(25) y se señala que los incrementos de 20 ml/kg al día son seguros. En el presente estudio, se confirmó la seguridad de este incremento, en la medida en que la incidencia de enterocolitis en los dos grupos de pacientes fue similar, ambos dentro de valores razonables (26,27).…”

Section: Discussionunclassified

“…Además, algunos estudios han encontrado que el inicio temprano de la vía oral no aumenta el riesgo de enterocolitis (16,17). Igualmente, se discute el papel que podría jugar la velocidad en los incrementos de la vía oral (18), aunque algunos estudios no encuentran relación alguna (19,20).…”

unclassified

See 2 more Smart Citations

Incidencia de enterocolitis necrosante en niños prematuros alimentados precozmente

et al. 2011

View full text Add to dashboard Cite

Introducción. La enterocolitis necrosante es una catástrofe multifactorial de los recién nacidos, generada por vasoconstricción visceral. Se discute el papel que juega el momento, tipo y velocidad de los incrementos de la vía oral en la patogenia de la entidad. Objetivo. Comparar la incidencia de enterocolitis necrosante y la mortalidad entre prematuros en quienes se inició alimentación entérica a las 48 horas de vida extrauterina, frente a otros en quienes se empezó al quinto día de vida. Materiales y métodos. Se llevó a cabo un ensayo clínico controlado de 239 neonatos de 750 a 1.500 gramos de peso y de 27 a 32 semanas de edad de gestación, asignados al azar, 135 a alimentación temprana y 104 a alimentación tardía con leche materna o fórmula láctea para prematuros. Se inició con un mililitro cada seis horas, para progresar en intervalos de tres horas y un incremento diario de hasta 20 ml/kg hasta llegar a 150 ml/kg al día, siempre y cuando no se observaran signos o síntomas de intolerancia a la vía oral. Resultados. Se presentaron 14 casos de enterocolitis necrosante en el grupo de alimentación temprana (10,4 %) y nueve (8,7 %) en el de alimentación tardía (RR=1,22; IC 95 % 0,49-3,20; p=0,652). Cinco (3,7 %) niños fallecieron en el grupo de alimentación temprana (IC 95 % 1,4-8,9) y ocho (7,7 %), en el de alimentación tardía (IC 95 % 3,6-15,0), sin que estas diferencias fueran significativas (RR=0,46; IC 95 % 0,12-1,60; p=0,182). Conclusión. El iniciar en forma temprana la alimentación entérica en neonatos prematuros no aumenta el riesgo de enterocolitis necrosante ni el de mortalidad y sí representa grandes ventajas para estos pacientes.Palabras clave: enterocolitis necrosante, alimentación entérica, leche humana, recién nacido. Necrotizing enterocolitis among preterm newborns with early feedingIntroduction. The development of necrotizing enterocolitis is a common and serious risk to newborns. It is caused by splanchnic bed vasoconstriction that can produce intestinal necrosis. The role of onset time, type and, speed enhancements of The factors of enteral feeding related with necrotizing enterocolitis genesis such as feeding onset, type and frequency are not well understood. Objective. The incidence of necrotizing enterocolitis and mortality among infants will be compared in infants whose enteral feeding was initiated 48 hours after birth to those whose feeding began on day 5 postpartum. Materials and methods. A controlled clinical trial was conducted among 239 newborns weighing between 750-1,500 g and a gestation age of 27-32 weeks of gestational age. The infants were randomly assigned to two groups--135 to an early feeding regime and 104 to delayed feeding. Breast milk or formula milk was used. Feeding was begun with one ml every six hours, progressing to three hour intervals and 20 ml/kg daily. This was increased to 150 ml/kg-d if the infant condition remained stable and it manifested no oral intolerance. Contribuciones de los autores:Luis Alfonso Pérez: diseño, captación de pacientes, análisis y elaboració...

show abstract

Section: Discussionunclassified

See 1 more Smart Citation

Incidencia de enterocolitis necrosante en niños prematuros alimentados precozmente

et al. 2011

View full text Add to dashboard Cite

show abstract

“…33 This recommendation has found wide acceptance, although its validity has not been confirmed. In the only prospective randomized trial, Rayyis et al 34 compared increments of 15 ml/kg/ day with increments of 35 ml/kg/day. They found, as was to be expected, that with fast advancement, full intakes were achieved sooner and weight gain set in earlier.…”

Section: Initiation and Advancement Of Enteral Feedingsmentioning

confidence: 99%

Pragmatic Approach to In-Hospital Nutrition in High-Risk Neonates

Adamkin

2005

J Perinatol

View full text Add to dashboard Cite

“…The work under discussion that also could not develop a successful predictive model is the culmination of a tremendous effort of investigators and financial resources across multiple children's hospitals in the United States and is clearly one of the best efforts to date. Prospective studies [7][8][9][10][11][12][13][14] including the one in this edition along with retrospective studies 15,16 have failed to identify clinical factors that might allow us to identify narrowly infants at highest risk. Thus, it is clear that future efforts by these same networks must focus on genetic, proteomic and/or microbiologic investigations.…”

mentioning

confidence: 99%

Necrotizing Enterocolitis: Finding Infants at Highest Risk

Abdullah

2008

J Perinatol

View full text Add to dashboard Cite

Despite decades of research, necrotizing enterocolitis (NEC) remains one of the conditions within our neonatal intensive care units with the highest mortality. Experience has garnered the common realization that preterm infants and those requiring surgical therapy will fare the worst. However, clear clinical predictors to identify positively which infants will progress with the disease remain elusive.In this edition of The Journal of Perinatology, Moss and other investigators from six children's hospital across the United States present their data from their prospective, observational study. Although a negative study in which no new model could be developed to predict NEC, the analysis is an important contribution to further expand our knowledge of the risk factors for NEC progression. Dr Moss and colleagues characterized 455 infants with NEC into 'nonprogressors' who reached full feeding without surgical therapy or 'progressors' who either required surgical therapy or died from disease. Dedicated research nurses from the network collected data from a wide array of maternal, antenatal, intrapartum and newborn histories. Extensive daily feeding data including the mode and specific type of formula and/or total parenteral nutrition combination were also collected. Infants were followed during their inpatient hospitalization and extensive clinical data were collected relating to medications, radiology findings, ventilatory requirements, fluid and blood culture status. If infants received surgical therapy, surgical findings and postoperative data were also included in the analysis. The authors identified independent risk factors for progression of disease, with a particular focus on clinical information available at the time of diagnosis. Univariate analysis revealed NEC and progression to be associated with factors such as early gestational age, decreased birthweight, maternal age, intubation, compressions and portal venous gas, among others. Multivariate analysis identified 12 risk factors with 3 not previously described: teenaged mother, never have received enteral feeds before diagnosis and receipt of cardiac compressions/resuscitative drugs at delivery. Previously described risk factors were confirmed including factors such as Gramnegative bacteremia, portal venous gas, pneumatosis, metabolic acidosis at diagnosis, bandemia and low birth weight.One of the most interesting findings of this paper is the progression of NEC in infants who had never received enteral feeds. One plausible explanation for this finding might be that infants with NEC were being diagnosed early in life and thus may have

show abstract

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

Cited by 164 publications

References 13 publications

Incidencia de enterocolitis necrosante en niños prematuros alimentados precozmente

Incidencia de enterocolitis necrosante en niños prematuros alimentados precozmente

Pragmatic Approach to In-Hospital Nutrition in High-Risk Neonates

Necrotizing Enterocolitis: Finding Infants at Highest Risk

Contact Info

Product

Resources

About