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Updated: Sep 13, 2025
A Piglet Model of Neonatal Hypoxic-Ischemic Encephalopathy
Published on: May 16, 2015
Predictive model for feeding intolerance in neonates with hypoxic ischemic encephalopathy during therapeutic
Zhongping Shui1, Ying Liu1, Haimei Duan1
1Department of Neonatology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Abstract:
To construct a nomogram for feeding intolerance (FI) during therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE). 179 neonates with HIE were recruited between March 2017 and July 2023 and clinical data subjected to least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analysis. A predictive model was constructed and verified by receiver operating characteristic (ROC) curve analysis, calibration plots and decision curve analysis (DCA). Neonatal infection, 5-min Apgar score, hypoglycemia, time of enteral nutrition initiation, initial enteral feeding volume (15-30 mL/kg/day) and rate of feeding advancement (1-5 mL/kg/day) were found to be independent predictors for FI. Earlier initiation, larger initial volume and rapid feeding progression increased FI risk and slow advancement was protective. ROC analysis gave an area under the curve (AUC) of 0.83 (95% CI: 0.77-0.89) and internal verification concordance index (C-index) was 0.829. DCA showed a favorable net clinical benefit for the FI predictive model. The predictive model may identify the causes of FI at an early stage and inform clinical decisions.
