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[Early enteral feeding of infants with lower respiratory infections]
1Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile.
Insights
Enteral feeding via nasogastric tube significantly improved clinical outcomes for infants with lower respiratory infections (LRI), reducing hospital stays and respiratory distress. Oral feeding was less effective for these pediatric patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutrition
Background:
- Reduced food intake during acute lower respiratory tract infections (LRI) can negatively impact illness progression.
- Optimizing nutritional support is crucial for managing pediatric respiratory illnesses.
Purpose of the Study:
- To evaluate the efficacy of enteral feeding in improving the clinical course of lower respiratory infections (LRI) in infants.
- To compare nasogastric tube feeding (intermittent and continuous) with ad-libitum oral feeding in pediatric LRI patients.
Main Methods:
- A randomized controlled trial involving 42 infants (2-12 months) with LRI receiving standard antibiotic and salbutamol therapy.
- Infants were allocated to three groups: intermittent nasogastric (NG) bolus feeding, continuous NG drip feeding, or ad-libitum oral feeding.
- Nutritional intake, hospital stay duration, respiratory failure index, and heart rate were monitored.
Main Results:
- Infants receiving NG feeding (both intermittent and continuous) had significantly shorter hospital stays (8.7 and 8.4 days) compared to oral feeding (9.8 days).
- Enteral feeding groups showed faster improvement in the respiratory failure index and a greater decrease in heart rate.
- Energy intake increased significantly in all groups within the first three days, but NG feeding facilitated higher sustained intake.
Conclusions:
- Enteral feeding via nasogastric tube is an effective method for improving clinical outcomes in infants with lower respiratory tract infections.
- Nasogastric tube feeding accelerates recovery and reduces the severity of respiratory distress compared to oral feeding in this pediatric population.
- No adverse effects were observed with nasogastric tube feeding, supporting its safety and utility.
Abstract:
A decrease in food intake during the acute phase of lower respiratory tract infections may affect the course of illness. To determine if enteral feeding improves the clinical course of lower respiratory infections (LRI) we studied 42 infants (2 to 12 months of age) with LRI which were given antibiotics and salbutamol therapy based on clinical and X-ray findings. On admission to the hospital patients were randomly allocated to group A (fed by nasogastric tube as intermittent bolus); group B (infants fed by continuous drip via nasogastric tube) and group C (subjects fed ad-libitum by the oral route). Feedings consisted of powdered whole cow's milk formula, reconstituted to 7.5% (W/V), with added sucrose 5% and maltodextrin 5% (77 kcal/dl). Energy intake in group A increased from 69 to 110 kcal.kg.day; in group B, from 68 to 114 kcal.kg.day, and in group C, from 55 to 109 kcal.kg.day (ANOVA, p < 0.005 for the first three days). Infants of groups A and B had shorter hospital stays than C (8.7 and 8.4 vs. 9.8 days, ANOVA, p < 0.02) and a faster improvement of respiratory failure index (4.1 and 3.8 vs. 5.5. days, p < 0.001). Groups A and B also showed greater decrease in their heart rates (mean 170 down to 134 beats/min) than group C patients (169 down to 142 beats/min), p < 0.01 at discharge from the hospital. No differences were noted in trends of respiratory rate, weight/length, albuminemia, C-reactive protein, erythro-sedimentation rate or glycemia. No adverse effects of nasogastric tube feeding were observed.(ABSTRACT TRUNCATED AT 250 WORDS)