Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns

(1) Background: The tolerance of preterm newborns for the high nutritional intakes given by parenteral nutrition (PN) is still debated because of the risk of metabolic complications. Despite enteral nutrition (EN) being the preferred route of nutrition, an exclusive enteral feeding is not always pos...

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Autores principales:	Giovanni Boscarino, Maria Giulia Conti, Maria Di Chiara, Marco Bianchi, Elisa Onestà, Francesca Faccioli, Giorgia Deli, Paola Repole, Salvatore Oliva, Francesco Cresi, Gianluca Terrin
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hyperglycemia hypertriglyceridemia metabolic acidosis very low birth weight (VLBW) enteral nutrition critical condition Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/2a795557f182407c8c19efc022734a6e
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spelling	oai:doaj.org-article:2a795557f182407c8c19efc022734a6e2021-11-25T18:34:55ZEarly Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns10.3390/nu131138862072-6643https://doaj.org/article/2a795557f182407c8c19efc022734a6e2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3886https://doaj.org/toc/2072-6643(1) Background: The tolerance of preterm newborns for the high nutritional intakes given by parenteral nutrition (PN) is still debated because of the risk of metabolic complications. Despite enteral nutrition (EN) being the preferred route of nutrition, an exclusive enteral feeding is not always possible, as in preterm newborns, the gut is immature and less tolerant of EN. We aimed to study the impact of a minimal enteral feeding (MEF) on the possible early metabolic complications of PN in a cohort of preterms with gestational age at birth GA ≤ 29 + 6/7 weeks of postmenstrual age. (2) Methods: We divided the study sample in two cohorts: 1) Late-Feeding (cohort 1), newborns who received MEF starting from the 8th day of age, and (2) Early-Feeding (cohort 2), newborns who received MEF, consisting of the administration of at least 4–5 mL/kg/day by the enteral route, in the first 7 days of age. The primary outcome of the study was the rate of at least one metabolic complication, including hyperglycemia, hypertriglyceridemia, or metabolic acidosis. (3) Results: We enrolled 80 newborns (Late-Feeding cohort 51 vs. Early-Feeding cohort 29). The rate of all metabolic complications was statistically higher in the Late-Feeding cohort compared to the Early-Feeding cohort. Binary logistic regression analysis showed that late administration of MEF negatively influenced the rate of all metabolic complications. (4) Conclusions: Early minimal administration of EN is associated with less frequent PN-related metabolic side effects and a higher rate of survival in critically ill newborns.Giovanni BoscarinoMaria Giulia ContiMaria Di ChiaraMarco BianchiElisa OnestàFrancesca FaccioliGiorgia DeliPaola RepoleSalvatore OlivaFrancesco CresiGianluca TerrinMDPI AGarticlehyperglycemiahypertriglyceridemiametabolic acidosisvery low birth weight (VLBW)enteral nutritioncritical conditionNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3886, p 3886 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hyperglycemia hypertriglyceridemia metabolic acidosis very low birth weight (VLBW) enteral nutrition critical condition Nutrition. Foods and food supply TX341-641
spellingShingle	hyperglycemia hypertriglyceridemia metabolic acidosis very low birth weight (VLBW) enteral nutrition critical condition Nutrition. Foods and food supply TX341-641 Giovanni Boscarino Maria Giulia Conti Maria Di Chiara Marco Bianchi Elisa Onestà Francesca Faccioli Giorgia Deli Paola Repole Salvatore Oliva Francesco Cresi Gianluca Terrin Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
description	(1) Background: The tolerance of preterm newborns for the high nutritional intakes given by parenteral nutrition (PN) is still debated because of the risk of metabolic complications. Despite enteral nutrition (EN) being the preferred route of nutrition, an exclusive enteral feeding is not always possible, as in preterm newborns, the gut is immature and less tolerant of EN. We aimed to study the impact of a minimal enteral feeding (MEF) on the possible early metabolic complications of PN in a cohort of preterms with gestational age at birth GA ≤ 29 + 6/7 weeks of postmenstrual age. (2) Methods: We divided the study sample in two cohorts: 1) Late-Feeding (cohort 1), newborns who received MEF starting from the 8th day of age, and (2) Early-Feeding (cohort 2), newborns who received MEF, consisting of the administration of at least 4–5 mL/kg/day by the enteral route, in the first 7 days of age. The primary outcome of the study was the rate of at least one metabolic complication, including hyperglycemia, hypertriglyceridemia, or metabolic acidosis. (3) Results: We enrolled 80 newborns (Late-Feeding cohort 51 vs. Early-Feeding cohort 29). The rate of all metabolic complications was statistically higher in the Late-Feeding cohort compared to the Early-Feeding cohort. Binary logistic regression analysis showed that late administration of MEF negatively influenced the rate of all metabolic complications. (4) Conclusions: Early minimal administration of EN is associated with less frequent PN-related metabolic side effects and a higher rate of survival in critically ill newborns.
format	article
author	Giovanni Boscarino Maria Giulia Conti Maria Di Chiara Marco Bianchi Elisa Onestà Francesca Faccioli Giorgia Deli Paola Repole Salvatore Oliva Francesco Cresi Gianluca Terrin
author_facet	Giovanni Boscarino Maria Giulia Conti Maria Di Chiara Marco Bianchi Elisa Onestà Francesca Faccioli Giorgia Deli Paola Repole Salvatore Oliva Francesco Cresi Gianluca Terrin
author_sort	Giovanni Boscarino
title	Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
title_short	Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
title_full	Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
title_fullStr	Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
title_full_unstemmed	Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns
title_sort	early enteral feeding improves tolerance of parenteral nutrition in preterm newborns
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2a795557f182407c8c19efc022734a6e
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Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns

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