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Neonatology. 2018;113(4):347-352. doi: 10.1159/000487848. Epub 2018 Mar 6.

Enteral Feeding as an Adjunct to Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy.

Author information

1
Department of Pediatrics, University of Florida, Gainesville, Florida, USA.
2
UF Health Jacksonville, Jacksonville, Florida, USA.
3
St. Joseph's Hospital Tampa, Tampa, Florida, USA.
4
Department of Radiology, University of Florida, Gainesville, Florida, USA.
5
Department of Agricultural and Biological Engineering, Biostatistics and Statistics, University of Florida, Gainesville, Florida, USA.

Abstract

BACKGROUND:

Withholding enteral feedings during hypothermia lacks supporting evidence.

OBJECTIVES:

We aimed to determine if minimal enteral nutrition (MEN) during hypothermia in patients with hypoxic-ischemic encephalopathy was associated with a reduced duration of parenteral nutrition, time to full oral feeds, and length of stay, but would not be associated with increased systemic inflammation or feeding complications.

METHODS:

We performed a pilot, retrospective, matched case-control study within the Florida Neonatal Neurologic Network from December 2012 to May 2016 of patients who received MEN during hypothermia (n = 17) versus those who were not fed (n = 17). Length of stay, feeding-related outcomes, and brain injury identified by MRI were compared. Serum inflammatory mediators were measured at 0-6, 24, and 96 h of life by multiplex assay. MRI were scored using the Barkovich system.

RESULTS:

MEN subjects had a reduced length of hospital stay (mean 15 ± 11 vs. 24 ± 19 days, p < 0.05), days receiving parenteral nutrition (7 ± 2 vs. 11 ± 6, p < 0.05), and time to full oral feeds (8 ± 5 vs. 18 ± 18, p < 0.05). MEN was associated with a significantly reduced serum IL-12p70 at 24 and 96 h (p < 0.05). Brain MRI scores were not significantly different between groups.

CONCLUSION:

MEN during hypothermia was associated with a reduced length of stay and time to full feeds, but did not increase feeding complications or systemic inflammation.

KEYWORDS:

Feeding; Hypothermia; Inflammation

PMID:
29510382
DOI:
10.1159/000487848
[Indexed for MEDLINE]

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