Document Detail

Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants.
MedLine Citation:
PMID:  9279175     Owner:  NLM     Status:  MEDLINE    
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 chi 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 discharge, but did not decrease pulmonary morbidity or shorten hospital stay.
D C Wilson; P Cairns; H L Halliday; M Reid; G McClure; J A Dodge
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  77     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-11     Completed Date:  1997-09-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F4-11     Citation Subset:  AIM; IM    
Royal Maternity Hospital, Belfast, Northern Ireland.
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MeSH Terms
Bacterial Infections / physiopathology,  prevention & control
Bronchopulmonary Dysplasia / physiopathology,  prevention & control
Energy Intake
Enteral Nutrition*
Enterocolitis, Pseudomembranous / physiopathology,  prevention & control
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Infant, Very Low Birth Weight* / growth & development
Odds Ratio
Parenteral Nutrition*
Prospective Studies
Regression Analysis
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / physiopathology,  therapy*
Statistics, Nonparametric
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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