Enteral Nutrition in Neonates on Inotropic Support Admitted to a Tertiary Neonatal Intensive Care Unit: A Prospective...

Area of Science:

• Neonatalogy
• Pediatric Critical Care
• Clinical Nutrition

Background:

• Early enteral feeding in neonates on inotropic support may offer better outcomes than intravenous fluids.
• However, the safety and optimal inotrope levels for initiating enteral nutrition remain unclear.

Purpose of the Study:

• To assess early enteral feeding versus intravenous fluids in neonates on inotropic support.
• To compare clinical outcomes including hospital stay, morbidity, and mortality.
• To evaluate the safety and determine optimal inotrope levels for enteral nutrition tolerance.

Main Methods:

• A prospective cohort study involving 142 neonates with fluid-nonresponsive shock.
• Comparison between an enteral nutrition group and an intravenous fluid group.
• Statistical analysis using independent samples t-test, Mann-Whitney U test, chi-square, and Fisher's exact test (p<0.05 significance).

Main Results:

• The enteral nutrition group showed a higher percentage of improved and discharged neonates (87.32%) compared to the intravenous fluid group (78.87%).
• Mean time to full feeds (6.04 days) and duration of NICU stay (7.38 days) were significantly shorter in the enteral nutrition group (p<0.0001).
• The death rate was lower in the enteral nutrition group (8.45%) versus the intravenous fluid group (10.08%).

Conclusions:

• Early enteral feeding in neonates on inotropic support is associated with significantly shorter NICU stays, indicating improved clinical management.
• Adrenaline (0.1 mcg/kg) combined with dobutamine (10 mcg/kg) was identified as the optimal inotrope combination for enteral feed tolerance.