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Early enteral nutrition for upper digestive tract malformation in neonate
Weiwei Jiang1, Xiaofeng Lv1, Xiaoqun Xu1
1Nanjing Children's Hospital Affiliated to Nanjing Medical University, 72 Guangzhou Road, Nanjing 210008, China.
Insights
Early enteral nutrition (EEN) via jejunal feeding tube is safe and effective for neonates with congenital digestive tract obstructions, leading to shorter hospital stays and improved nutritional markers compared to traditional methods.
Area of Science:
- Pediatric Surgery
- Neonatal Nutrition
- Gastroenterology
Background:
- Early enteral nutrition (EEN) is generally preferred over total parenteral nutrition (TPN).
- Investigating the safety and feasibility of EEN using jejunal feeding tubes in neonates with congenital obstructions is crucial.
Purpose of the Study:
- To evaluate the safety and efficacy of EEN via jejunal feeding tubes in neonates post-operatively for congenital obstructions.
- To compare outcomes between neonates receiving EEN and a control group.
Main Methods:
- Retrospective review of 120 neonates with duodenal and jejunal congenital obstructions.
- Patients divided into EEN group (n=70) and control group (n=50).
- Key outcomes included operative time, time to oral feeding tolerance, hospital stay, and complication rates.
Main Results:
- EEN group showed significantly shorter time to oral feeding tolerance and reduced hospital stay.
- Significantly higher levels of total protein, pre-albumin, and retinol binding protein were observed in the EEN group.
- Lower incidence of cholestasis and obstruction in the EEN group compared to controls.
Conclusions:
- EEN with jejunal feeding tubes is a safe and feasible method for neonates with upper digestive tract malformations.
- This approach leads to fewer complications and improved nutritional status post-operatively.
Background:
Early enteral nutrition (EEN) is better than total parenteral nutrition (TPN) for many reasons. Our aim was to determine the safety and feasibility of EEN using a jejunum feeding tube in the duodenum or jejunum for congenital obstruction in neonates post-operatively.
Methods:
This was a retrospective review of 120 patients who had duodenal and jejunal congenital obstructions in our hospital. The patients were categorized into two groups (EEN group [n=70 patients] and control group [n=50 patients]). Differences in operative time, postoperative time to tolerate oral feeding (40 mL/3 h), post-operative hospital stay, and complications, such as catheter obstruction, diarrhea, and nutrition index, were reviewed.
Results:
The operative time and time to first defecation post-operatively was not significantly different between the two groups. The time to tolerate oral feeding (40 mL/3 h) and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. Total protein, pre-albumin, and retinol binding protein were significantly higher in the EEN group than the control group 14 days post-operatively. The incidence of cholestasis and obstruction in the EEN group was significantly lower than the control group, and the incidence of diarrhea was lower than the control group, but not significantly lower.
Conclusion:
EEN using a jejunal feeding tube in an upper digestive tract malformation in newborns post-operatively is safe, easy, and has fewer complications.
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