Suboptimal perioperative nutrition for extremely preterm infants undergoing surgical treatment for patent ductus arteriosus
ثبت نشده
چکیده
Background: In Sweden, 24% of extremely preterm (EPT) infants are treated with surgery for patent ductus arteriosus (PDA). EPT infants undergoing PDA surgery are at risk for suboptimal intake of energy and macronutrients caused by fluid restrictions and fear for starting enteral feeds after operation and because of that develop necrotizing enterocolitis (NEC). NEC is a medical condition primarily seen in premature infants where parts of the bowel undergo necrosis (tissue death). Objective: To evaluate perioperative nutrition in EPT infants undergoing surgery for patent ductus arteriousus (PDA). Methods: A population-based cohort of EPT infants born in Sweden during 2004-2007 and operated for PDA (n=140, 83 boys, mean birth weight 723 g). Data on perioperative nutrition was retrieved retrospectively from hospital records. All enteral and parenteral nutrients as well as blood products were used to calculate daily supply of energy, macronutrients and fluids, starting three days before and ending three days after surgery. We stratified postnatal age into three intervals: early neonatal (0-6 days), late neonatal (7-27 days) and post neonatal (>28 days). Data are shown as mean (standard deviations) and median (25 th ;75 th percentile). Results: Energy and macronutrient intakes were below minimal requirements before, during and after PDA surgery. Nutrition and fluid intakes did not vary in relation to gestational age, but infants operated early (0-6 days after birth) received poorer nutrition than infants operated at older age. Infants operated during late neonatal period (7-27 days after birth) had a higher fluid intake compared with infants in the other groups. Conclusions: Perioperative nutrition in EPT infants undergoing PDA-surgery in Sweden is suboptimal and needs to be improved. The significance of suboptimal nutrition for outcome after PDA-surgery is still unclear and requires further investigation.
منابع مشابه
Intravenous Paracetamol and Patent Ductus Arteriosus Closure
Background: Standard medical treatments for patent ductus arteriosus (PDA) closure are, including indomethacin/ibuprofen and surgical ligation. Nowadays, a new strategy to close PDA is the use of paracetamol. The present study aimed to describe the use of intravenous (IV) paracetamol for PDA closure in neonates who present a contraindication to ibuprofen or ibuprofen failure with no possibility...
متن کاملEarly and late outcome of treatment with oral ibuprofen in preterm infants suffering from patent ductus arteriosus: A randomized clinical trial
Background and Objective: Nonsteroidal anti-inflammatory agents are the treatment of choice for ductal closure in premature newborn. This study evaluates early and late outcome, as well as the effectiveness of oral ibuprofen in the treatment of patent ductus arteriosus (PDA) in premature infants. Methods: In this clinical trial, all preterm infants below 37 weeks, with documentation of PDA w...
متن کاملPatent ductus arteriosus, indomethacin and necrotizing enterocolitis in very low birth weight infants: a population-based study.
BACKGROUND Patent ductus arteriosus is a risk factor for the development of necrotizing enterocolitis. The use of indomethacin to treat patent ductus arteriosus in preterm infants may either decrease the incidence of necrotizing enterocolitis by stabilizing or closing the ductus arteriosus or increase its incidence by a direct constricting effect on mesenteric blood vessels. The authors sought ...
متن کاملAtrial natriuretic peptide and patent ductus arteriosus in preterm infants.
Preterm infants with symptomatic patent ductus arteriosus had considerably raised plasma concentrations of atrial natriuretic peptide. Surgical ligation of the patent ductus arteriosus was associated with an immediate fall in plasma atrial natriuretic peptide concentration. Thus left to right shunting and left atrial distension may cause atrial natriuretic peptide release in preterm infants wit...
متن کاملThe Timing of Surgical Ligation for Patent Ductus Arteriosus Is Associated with Neonatal Morbidity in Extremely Preterm Infants Born at 23-25 Weeks of Gestation
The purpose of this study was to evaluate prognostic factors associated with surgical ligation for patent ductus arteriosus (PDA) in extremely preterm infants born at the limits of viability. Ninety infants who were born at 23-25 weeks of gestation and who received surgical ligation were included and their cases were retrospectively reviewed. Infants were classified into two different groups: s...
متن کامل