Reduction in necrotising enterocolitis after implementing an evidence-based enteral nutrition protocol in very low birth weight newborns

AbstractThe aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks’ gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period ‘before’ (Period I) and ‘after’ (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks’ gestation.

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Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd001241.pub7 ◽

2017 ◽

Cited By ~ 16

Author(s):

Sam J Oddie ◽

Lauren Young ◽

William McGuire

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Necrotising Enterocolitis ◽

Low Birth Weight Infants

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Gastric residual volume as a measure of feed intolerance/necrotising enterocolitis in very low birth weight infants: an observational cohort study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200124 ◽

2020 ◽

Vol 7 (2) ◽

pp. 432

Author(s):

Rahul M. Kadam ◽

Lakshmi Aparna Devi V. V.

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Observational Cohort Study ◽

Necrotising Enterocolitis ◽

Residual Volume ◽

Gastric Residual Volume ◽

Observational Cohort ◽

Feed Intolerance

Background: To evaluate the efficacy of Gastric Residual Volume (GRV) as a measure of feed intolerance /Necrotising enterocolitis in Very Low Birth Weight (VLBW) infants.Methods: This prospective observational cohort study was done in a tertiary care hospital located in rural South India for a period of 2 years. All haemodynamically stable infants born between 30-34 weeks of gestation at birth and 1000-1500 grams of birth weight, admitted to Neonatal Intensive Care Unit (NICU) within first 24 hours of life during study period were enrolled in two groups; GRV group, where pre-feed gastric residual volume was checked and No-GRV group, where pre-feed gastric residual volume was not checked.Results: Both groups had similar baseline characteristics. In No-GRV group, the days to reach birth weight (12.1) and days to attain full feeds (8.0) were less when compared to GRV group. In No-GRV group, average duration of NICU stay in days (16.60) and parenteral nutrition (5.25) was less when compared to GRV group. No-GRV group does not have increased incidence of sepsis or mortality compared to GRV group. In this study there was increased incidence of NEC noted in GRV group (30%) when compared to No-GRV group (p value-0.02).Conclusions: In hemodynamically stable preterm VLBW infants, it is recommended not to check gastric residual volume routinely prior to the enteral feeding.

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