%0 Journal Article
%T Incidence of necrotizing enterocolitis among preterm newborns with early feeding. A clinical trial Incidencia de enterocolitis necrosante en ni os prematuros alimentados precozmente
%A Luis Alfonso P谷rez
%A Germ芍n Lauro Pradilla
%A Gaby D赤az
%A Sandra Mar赤a Bayter
%J Biom谷dica
%D 2011
%I Instituto Nacional de Salud
%X Introduction. Necrotizing enterocolitis is a multifactorial catastrophe to newborns; it is caused by splacnich bed vasoconstriction that produce intestinal necrosis. The role of onset time, type and, speed enhancements of enteral feeding related with necrotizing enterocolitis genesis are discussed today. Objective. To compare the incidence of necrotizing enterocolitis and mortality among infants in whom enteral feeding was started 48 hours after birth compared to others that began on the fifth day of life. Materials and methods. Controlled clinical trial was conducted among 239 newborns between 750 to 1.500 g and 27-32 weeks of gestational age, randomly assigned 135 to early feeding and 104 to delayed feeding; breast milk or formula milk for infants were used. Feeding began with one mL every six hours, to progress at three hours intervals daily and increased to 20 mL/kg-d to reach 150 mL/kg-d while any patient remained stable and showed no oral intolerance manifestations. Results. There were 14 necrotizing enterocolitis cases in early feeding group (10.4%) and nine (8.7%) in late feeding one (RR= 1.22, 95% CI 0.49-3.20, p= 0.652). Five children died in early feeding group (3.7%, 95% CI 1.4-8.9) and eight in late feeding one (7.7%, 95% CI 3.6-15.0, RR= 0.46, 95% CI 0.12-1,60, p= 0.182). Conclusion. The start in early enteral feeding in preterm newborns does not increase the risk of necrotizing enterocolitis or mortality among them, and does represent great advantages for these patients. Introducci車n. La enterocolitis necrosante es una cat芍strofe multifactorial de los reci谷n nacidos, generada por vasoconstricci車n visceral. Se discute el papel que juega el momento, tipo y velocidad de los incrementos de la v赤a oral en la patogenia de la entidad. Objetivo. Comparar la incidencia de enterocolitis necrosante y la mortalidad entre prematuros en quienes se inici車 alimentaci車n ent谷rica a las 48 horas de vida extrauterina, frente a otros en quienes se empez車 al quinto d赤a de vida. Materiales y m谷todos. Se llev車 a cabo un ensayo cl赤nico controlado de 239 neonatos de 750 a 1.500 gramos de peso y de 27 a 32 semanas de edad de gestaci車n, asignados al azar, 135 a alimentaci車n temprana y 104 a alimentaci車n tard赤a con leche materna o f車rmula l芍ctea para prematuros. Se inici車 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 d赤a, siempre y cuando no se observaran signos o s赤ntomas de intolerancia a la v赤a oral. Resultados. Se presentaron 14 casos de enterocolitis necrosante en
%K enterocolitis necrosante
%K alimentaci車n ent谷rica
%K leche humana
%K reci谷n nacido.
%U http://www.revistabiomedica.org/index.php/biomedica/article/view/397