Early parenteral nutrition in neonates with congenital diaphragmatic hernia.
The ideal nutritive strategy for neonate with congenital diaphragmatic hernia (CDH) has not been elucidated. The purpose of this study was to investigate the efficacy of early parenteral nutrition (PN) in CDH neonates.
Thirty-five CDH neonates encountered from January 2005 to December 2014 at a single hospital were retrospectively reviewed. For the first four years of the study period, neonates received non-early PN (n-EPN) (2005-08, amino acids [AA] < 1.0 g/kg/day, no lipids administered). After the transitional period (TP) (2009-11, AA 1.0-2.5 g/kg/day, lipid 1.0 g/kg/day), early PN (EPN) (2011-14, AA ≥ 3.0 g/kg/day, lipid 1.0 g/kg/day) was performed. We investigated the clinical effect of PN for growth-associated clinical variables and the outcomes.
The first day of AA administration was late in n-EPN. The final day of PN and the first day of enteral feeding, the first day of full milk feeding (100 ml/kg/day) were statistically equal in every periods. The date and body weight at discharge showed no significant differences among three groups, but the weight gain rate from birth to discharge was higher in the EPN group than in the n-EPN group (p = 0.023). The rate of inhaled NO gas administration and the duration of ventilation showed no significant differences among three groups. Severe PN-associated liver disease was not noted during the observation period.
EPN for CDH neonates promotes weight gain in the neonatal intensive-care unit. The long-term efficacy and safety of EPN for CDH neonates should be elucidated by additional studies.
© 2019 Japan Pediatric Society.
congenital diaphragmatic hernia; neonate; parenteral nutrition; parenteral nutrition-associated liver disease; persistent pulmonary hypertension of the newbornPMID: 31811685 DOI: 10.1111/ped.14083