Impact of nutrition in the treatment of congenital diaphragmatic hernia.


Journal

Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Titre abrégé: Pediatr Int
Pays: Australia
ID NLM: 100886002

Informations de publication

Date de publication:
May 2019
Historique:
received: 31 07 2018
revised: 06 01 2019
accepted: 07 03 2019
pubmed: 20 3 2019
medline: 2 1 2020
entrez: 20 3 2019
Statut: ppublish

Résumé

The optimum enteral (EN) and parenteral nutrition (PN) regimens during acute management of congenital diaphragmatic hernia (CDH) remain unclear. We examined the effects of EN and PN on weight gain in CDH patients. A multicenter retrospective cohort study of neonates with CDH (born 2006-2010; n = 105) who survived to discharge was conducted. Patients were divided as receiving PN ≥ or <50 kcal/kg/day at 1 week of age, and EN ≥ or <60 kcal/kg/day at 2 weeks of age. Changes in bodyweight at 30, 60, and 90 days of age were compared. The higher EN group (n = 39) had greater mean weight gain than the lower EN group (n = 66; 90 days: 2,501 g, 95% CI: 2,294-2,710 g vs 1,706 g, 95% CI: 1,553-1,861 g; P <0.001). When patients received lower EN, the higher PN group (n = 24) had greater mean weight gain than the lower PN group (n = 42; 90 days: 1,768 g, 95% CI: 1,574-1,961 g vs 1,411 g, 95% CI: 1,264-1,558 g; P = 0.004). The amount of EN in the acute phase of CDH management is essential for weight gain during infancy. When patients are intolerant to adequate EN, supportive PN is also essential.

Sections du résumé

BACKGROUND BACKGROUND
The optimum enteral (EN) and parenteral nutrition (PN) regimens during acute management of congenital diaphragmatic hernia (CDH) remain unclear. We examined the effects of EN and PN on weight gain in CDH patients.
METHODS METHODS
A multicenter retrospective cohort study of neonates with CDH (born 2006-2010; n = 105) who survived to discharge was conducted. Patients were divided as receiving PN ≥ or <50 kcal/kg/day at 1 week of age, and EN ≥ or <60 kcal/kg/day at 2 weeks of age. Changes in bodyweight at 30, 60, and 90 days of age were compared.
RESULTS RESULTS
The higher EN group (n = 39) had greater mean weight gain than the lower EN group (n = 66; 90 days: 2,501 g, 95% CI: 2,294-2,710 g vs 1,706 g, 95% CI: 1,553-1,861 g; P <0.001). When patients received lower EN, the higher PN group (n = 24) had greater mean weight gain than the lower PN group (n = 42; 90 days: 1,768 g, 95% CI: 1,574-1,961 g vs 1,411 g, 95% CI: 1,264-1,558 g; P = 0.004).
CONCLUSION CONCLUSIONS
The amount of EN in the acute phase of CDH management is essential for weight gain during infancy. When patients are intolerant to adequate EN, supportive PN is also essential.

Identifiants

pubmed: 30888699
doi: 10.1111/ped.13837
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

482-488

Subventions

Organisme : Ministry of Health, Labour and Welfare of Japan
ID : H24-Nanchi-Ippan-034, 2002

Informations de copyright

© 2019 Japan Pediatric Society.

Auteurs

Keita Terui (K)

Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Noriaki Usui (N)

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.

Yuko Tazuke (Y)

Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Kouji Nagata (K)

Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi, Fukuoka, Japan.

Miharu Ito (M)

Center for Maternal-Neonatal Care, Nagoya University Hospital, Showa, Nagoya, Japan.

Hiroomi Okuyama (H)

Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Masahiro Hayakawa (M)

Center for Maternal-Neonatal Care, Nagoya University Hospital, Showa, Nagoya, Japan.

Tomoaki Taguchi (T)

Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Higashi, Fukuoka, Japan.

Yasunori Sato (Y)

Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku, Tokyo, Japan.

Hideo Yoshida (H)

Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

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