The requirements of growth and organ development create a challenge in nutritional management of newborn infants,especially premature newborn and intestinal-failure infants.Since their feeding may increase the risk of...The requirements of growth and organ development create a challenge in nutritional management of newborn infants,especially premature newborn and intestinal-failure infants.Since their feeding may increase the risk of necrotizing enterocolitis,some high-risk infants receive a small volume of feeding or parenteral nutrition (PN) without enteral feeding.This review summarizes the current research progress in the nutritional management of newborn infants.Searches of MEDLINE (1998-2007),Cochrane Central Register of Controlled Trials (The Cochrane Library,Issue 3,2007),abstracts and conference proceedings,references from relevant publications in the English language were performed,showing that breast milk is the preferred source of nutrients for enteral feeding of newborn infants.The number of nutrients found in human milk was recommended as a guideline in establishing the minimum and maximum levels in infant formulas.The fear of necrotizing enterocolitis and feeding intolerance are the major factors limiting the use of the enteral route as the primary means of nourishing premature infants.PN may help to meet many of the nutritional needs of these infants,but has significant detrimental side effects.Trophic feedings (small volume of feeding given at the same rate for at least 5 d) during PN are a strategy to enhance the feeding tolerance and decrease the side effects of PN and the time to achieve full feeding.Human milk is a key component of any strategy for enteral nutrition of all infants.However,the amounts of calcium,phosphorus,zinc and other nutrients are inadequate to meet the needs of the very low birth weight (VLBW) infants during growth.Therefore,safe and effective means to fortify human milk are essential to the care of VLBW infants.展开更多
AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP). METHODS: We searched Cochrane Central Register of Controlled Trials (Issue...AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP). METHODS: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration’s RevMan 4.2.9 software was used for statistical analysis. RESULTS: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable. Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87, 95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P = 0.41) or multiple organ defi ciency syndrome (RR = 0.97, 95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition. CONCLUSION: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP.Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed.展开更多
文摘The requirements of growth and organ development create a challenge in nutritional management of newborn infants,especially premature newborn and intestinal-failure infants.Since their feeding may increase the risk of necrotizing enterocolitis,some high-risk infants receive a small volume of feeding or parenteral nutrition (PN) without enteral feeding.This review summarizes the current research progress in the nutritional management of newborn infants.Searches of MEDLINE (1998-2007),Cochrane Central Register of Controlled Trials (The Cochrane Library,Issue 3,2007),abstracts and conference proceedings,references from relevant publications in the English language were performed,showing that breast milk is the preferred source of nutrients for enteral feeding of newborn infants.The number of nutrients found in human milk was recommended as a guideline in establishing the minimum and maximum levels in infant formulas.The fear of necrotizing enterocolitis and feeding intolerance are the major factors limiting the use of the enteral route as the primary means of nourishing premature infants.PN may help to meet many of the nutritional needs of these infants,but has significant detrimental side effects.Trophic feedings (small volume of feeding given at the same rate for at least 5 d) during PN are a strategy to enhance the feeding tolerance and decrease the side effects of PN and the time to achieve full feeding.Human milk is a key component of any strategy for enteral nutrition of all infants.However,the amounts of calcium,phosphorus,zinc and other nutrients are inadequate to meet the needs of the very low birth weight (VLBW) infants during growth.Therefore,safe and effective means to fortify human milk are essential to the care of VLBW infants.
文摘AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP). METHODS: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration’s RevMan 4.2.9 software was used for statistical analysis. RESULTS: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable. Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87, 95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P = 0.41) or multiple organ defi ciency syndrome (RR = 0.97, 95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition. CONCLUSION: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP.Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed.
