Research: Importance of nutrient balance in severe congenital diaphragmatic hernia: A retrospective case-control study

Clin Nutr ESPEN

. 2023 Oct;57:381-386.

 doi: 10.1016/j.clnesp.2023.07.078. Epub 2023 Jul 22. https://pubmed.ncbi.nlm.nih.gov/37739682/

Importance of nutrient balance in severe congenital diaphragmatic hernia: A retrospective case-control study

Masahiro Zenitani 1Yoshiyuki Shimizu 2Masayuki Yoshida 3Yuki Noguchi 4Rei Matsuura 5Satoshi Umeda 6Noriaki Usui 7

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Abstract

Background & aims: Growth retardation is a common morbidity in infants with severe congenital diaphragmatic hernia (CDH). This study aimed to investigate the appropriate amount of nutrition and nutrient balance in early infants with severe CDH.

Methods: This was a retrospective case-control study. Isolated CDH patients with more than half of the chest wall devoid of diaphragmatic tissue and treated between 2006 and 2022 were included. The patients were divided into positive (n = 16) or negative (n = 8) weight gain velocity groups in early infancy (from 1 to 3 months of age). Clinical variables and amount of nutrition were compared between the two groups.

Results: The earlier start of enteral nutrition (EN) and higher replacement rate of the naso-duodenal (ND) tube were observed more frequently in the positive group than in the negative group. Regarding daily intake by both EN and parenteral nutrition (PN), total caloric intake and caloric intake of proteins and lipids were significantly higher in the positive group than in the negative group at 1 month of age. At 2 months, total caloric intake and caloric intake of lipids were significantly higher in the positive group than in the negative group. At 3 months of age, only caloric intake of lipid was significantly higher in the positive group than in the negative group.

Conclusions: The early replacement of the ND tube may contribute to the early start of EN, which may subsequently lead to appropriate nutrient supplementation including adequate lipid administration, resulting in early catch-up growth.

Keywords: Enteral nutrition; Lipid; Naso-duodenal tube; Parenteral nutrition.

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