[Show abstract][Hide abstract] ABSTRACT: Objetivo
analisar as alterações dos macronutrientes gordura, proteína e lactose no leite humano natural, congelado e descongelado, após a simulação da administração da dieta por gavagem e infusão contínua.
foi conduzido um estudo experimental com 34 amostras de leite humano. Foi utilizada a técnica da espectofotometria infravermelha (Milko Scan Minor®) para analisar os macronutrientes do leite humano nas etapas do estudo. As amostras foram analisadas na forma natural (crua) e após congelamento e descongelamento rápido nas duas formas de infusão: gavagem e infusão contínua. Foi usado o teste não paramétrico de Wilcoxon para amostras pareadas na análise estatística.
a gordura apresentou redução significativa após administração por infusão contínua (p < 0,001), tanto durante administração na forma natural quanto na forma descongelada. Não houve alteração da proteína e lactose segundo forma de infusão no leite descongelado e no leite in natura. O processo de descongelamento aumentou significativamente os níveis de lactose e de proteína do leite.
a via de administração por infusão contínua foi o procedimento que mais influenciou na perda de gordura, dentre todos os processos necessários para administração do leite humano.
[Show abstract][Hide abstract] ABSTRACT: Nutrition of preterm infants should result in growth similar to that of normally growing fetuses of the same gestational age. Unfortunately, most preterm infants are not fed enough to achieve this objective; as a result they are growth restricted by term gestation. Recent studies have demonstrated that early and enhanced "aggressive" nutrition of preterm infants can reduce postnatal growth failure and improve longer-term outcomes, particularly for the brain and its cognitive functions. When preterm infants are fed more aggressively (earlier onset of intravenous and enteral feeding, earlier achievement of full enteral feeding) cumulative energy and protein deficits are reduced and they consistently regain birth weight sooner, the incidence of necrotizing enterocolitis and late-onset sepsis is unchanged or reduced, and they achieve discharge criteria and go home sooner, with overall shorter hospital stays, and have improved anthropometrics by term gestation. More research is needed, however, to determine optimum feeding of preterm infants, particularly during periods of illness and physiological instability.
[Show abstract][Hide abstract] ABSTRACT: Whether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate.
We studied 4005 hospitalized VLBW, very preterm (23-32 weeks' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003-2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement <10(th) percentile for postmenstrual age) at discharge.
40% of infants received parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates.
Even in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants.
PLoS ONE 02/2014; 9(2):e88392. · 3.53 Impact Factor
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