Early enteral feeding guided by intestinal ultrasound during therapeutic hypothermia for hypoxic-ischemic encephalopathy in neonates
10.3760/cma.j.issn.2096-2932.2023.03.002
- VernacularTitle:新生儿亚低温治疗期间肠道超声指导早期肠内喂养的临床研究
- Author:
Xiaoguang HE
1
;
Jianbo LI
;
Bang DU
;
Fengdan XU
;
Jingen LIE
Author Information
1. 东莞市儿童医院新生儿科，东莞 523325
- Keywords:
Therapeutic hypothermia;
Hypoxic-ischemic encephalopathy;
Enteral feeding;
Ultrasound;
Newborn
- From:Chinese Journal of Neonatology
2023;38(3):136-140
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and feasibility of early enteral feeding during therapeutic hypothermia guided by intestinal ultrasound in neonates with hypoxic-ischemic encephalopathy (HIE).Methods:From January 2019 to December 2021, neonates with HIE who received therapeutic hypothermia in the neonatology department of our hospital were retrospectively selected. They were assigned into the ultrasound-guided observation group (admitted from May 2020 to December 2021) and the control group (admitted from January 2019 to April 2020). In the ultrasound-guided observation group, intestinal ultrasound was performed during therapeutic hypothermia. Based on clinical manifestations and ultrasound results, a small amount of enteral feeding [20 ml/(kg·d)] was initiated and gradually increased to total enteral feeding after rewarming. In the control group, 5 ml (once every 3 h) of glucose and sodium chloride solution was given during 72 h of therapeutic hypothermia. After rewarming, enteral feeding was started and gradually increased to total enteral feeding without intestinal ultrasound. The time to start enteral feeding, the time to achieve total enteral feeding, the incidences of feeding intolerance, necrotizing enterocolitis (NEC) and late-onset sepsis were compared between the two groups.Results:A total of 17 cases were in the ultrasound-guided observation group and 18 cases in the control group. The median time to start enteral feeding and to achieve total enteral feeding in the ultrasound-guided observation group were earlier than the control group [36.0 (33.5, 39.0) h vs. 77.0 (74.0, 79.3) h, 6.0 (5.5, 6.5) d vs. 8.0 (7.0, 9.0) d, P<0.001]. No significant difference existed in the incidence of feeding intolerance between the two groups. Neither groups had NEC or late-onset sepsis. Conclusions:Early enteral feeding during therapeutic hypothermia in neonates with HIE is safe and feasible. Intestinal ultrasound helps implementing feeding plan and achieving early total enteral feeding.
