Nutritional Needs of the Infant with Bronchopulmonary Dysplasia
Audrey N Miller1, Jennifer Curtiss2, Matthew J Kielt1
1Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH.
Insights
Infants with bronchopulmonary dysplasia (BPD) often experience growth failure, impacting long-term health. Clinical protocols based on current evidence can optimize nutrition and improve outcomes for these vulnerable infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Respiratory Medicine
Background:
- Growth failure is prevalent in infants with bronchopulmonary dysplasia (BPD).
- Suboptimal growth in BPD is linked to adverse respiratory and neurodevelopmental outcomes.
- Limited high-quality evidence exists for optimal nutritional practices in BPD.
Purpose of the Study:
- To address the variation in nutritional care for infants with BPD.
- To explore the potential of clinical protocols in improving growth outcomes.
- To optimize nutritional management for vulnerable infants with BPD.
Main Methods:
- Review of systematic reviews and clinical recommendations.
- Application of best available evidence.
- Development of clinical protocols for nutritional management.
Main Results:
- Identified a lack of high-quality trials guiding BPD nutritional practice.
- Highlighted variation in current nutritional care and growth monitoring.
- Proposed a strategy to decrease care variation.
Conclusions:
- Clinical protocols can standardize and improve nutritional management for infants with BPD.
- Evidence-based guidelines are crucial for optimizing growth in this population.
- Further research is needed, but current evidence can guide practice.
Abstract:
Growth failure is a common problem in infants with established bronchopulmonary dysplasia (BPD). Suboptimal growth for infants with BPD is associated with unfavorable respiratory and neurodevelopmental outcomes; however, high-quality evidence to support best nutritional practices are limited for this vulnerable patient population. Consequently, there exists a wide variation in the provision of nutritional care and monitoring of growth for infants with BPD. Other neonatal populations at risk for growth failure, such as infants with congenital heart disease, have demonstrated improved growth outcomes with the creation and compliance of clinical protocols to guide nutritional management. Developing clinical protocols to guide nutritional management for infants with BPD may similarly improve long-term outcomes. Given the absence of high-quality trials to guide nutritional practice in infants with BPD, the best available evidence of systematic reviews and clinical recommendations can be applied to optimize growth and decrease variation in the care of these infants.
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